Vol. 3 No. 02 (2019)
Original Article

Effect of Prophylactic Oral Nystatin on Fungaemia Prevention among VLBW Neonates in NICU

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  • Mohammad Enamul Karim,
  • Ishrat Jahan,
  • Md. Kamrul Ahsan Khan,
  • Md. Abdul Mannan,
  • Habiba Anjuman,
  • Ferdous ara
Mohammad Enamul Karim
Registrar, National Heart Foundation Hospital and Research Institute
Ishrat Jahan
Asst. Registrar, Uttara Adhunik Medical College and Hospital
Md. Kamrul Ahsan Khan
Assistant Professor Neonatology. Sheikh Sayera Khatun Medical College. Gopalgonj
Md. Abdul Mannan
Chairman, Department of Neonatology. Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka
Habiba Anjuman
Asst. Registrar, Uttara Adhunik Medical College and Hospital, Dhaka
Ferdous ara
Registrar, Uttara Adhunik Medical College and Hospital, Dhaka

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Abstract

Introduction: Recent global estimates suggest that > 1 in 10 or an estimated 15 million babies born in 2010 were preterm, of which >1 million died as a result of prematurity and its complications. Bangladesh ranked the 7th on the top-10 country list for high preterm births in 2010. The risk of invasive fungal infections is high in very low birth weight (VLBW) infants (<1500 g) and highest for infants born at the youngest gestational ages who survive past theimmediate postnatal period. Overall mortality attributable to invasive candidiasis was 19.3%. Starting empiric antifungal therapy may decrease the high mortality rate of invasive fungaemia in VLBW infants, especially those born at <28 weeks' gestation. Objectives- To evaluate the efficacy of prophylactic oral Nystatin on fungaemia among VLBW neonates. Methodology- It was a RCT; conducted in NICU of the Department of Neonatology, BSMMU, Dhaka; from Dec.15 to Sept. 16. A total of 25 cases (Group-A) and 25 controls (Group-B) were included in this study purposively and grouped by lottery. Group-A got prophylactic Nystatin orally [1 ml (100000units/ml) every 6 hour started, 24 hours after initiation of feeding until discharged] and group B did not get any prophylactic anti-fungal medication. All the babies received supportive treatment as required. Results- Both groups showed similar pattern of distribution; regarding sex, gestational age, anthropometric measurements and vital parameters. For both groups, Jaundice was present in most neonates (>90.0%). Chest indrawing, Apnoea, Hyperglycaemia, Hypoglycaemia, Grunting and Cyanosis were mostnotable presentations. All the presentations showed higher ‘positive’ counts in ‘Group-B’ and there was some positive association for most of the factors (except Hypoglycaemia, Grunting, Cyanosis and Shock). Majority in Group-B needed Phototherapy, Ionotrop and respiratory support (either CPAP or ventilator) than Group-A. Feeding intolerance developed more in Group–B, though not significant (p-0.5558). None in Group–A but 24.0% neonates in Group–B had invasive fungaemia (p-0.009). Neonates of Group-A (16.96 ± 6.931days) had to stay at hospital for shorter duration than Group-B (26.84± 16.062days) for treatment (p-0.009). Death rate (due to any cause) was lower in Group-A group (12.0%) than Group-B group (28.0%). (p0.3057). Conclusion-. The study concludes, prophylactic oral nystatin in neonates reduces the frequency of developing fungaemia and also reduces duration of hospital stay.

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Published 21-09-2021

Keywords

  • Oral Nystatin,
  • Fungaemia,
  • VLBW,
  • NICU,
  • Prophylactic

How to Cite

1.
Karim ME, Jahan I, Khan MKA, Mannan MA, Anjuman H, ara F. Effect of Prophylactic Oral Nystatin on Fungaemia Prevention among VLBW Neonates in NICU. Planet (Barisal) [Internet]. 2021 Sep. 21 [cited 2024 Apr. 30];3(02):13. Available from: https://bdjournals.org/index.php/planet/article/view/32

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