PHARMACOKINETICS OF ORAL FLUCONAZOLE IN PREMATURE-INFANTS

Systemic infections with Candida albicans in neonates are a frequent a nd well recognized problem. The therapeutic gold standard in this situ ation is the combined intravenous antimycotic treatment with amphoteri cin B and flucytosine. Potential adverse effects of this regimen have encouraged the search for desirable alternatives. We report on the use of oral fluconazole in neonates with Candida albicans septicaemia. Th ree premature infants were treated with four courses of therapy. Pharm acokinetic studies were performed during each course. At oral doses of 4.5-6 mg/kg once a day, serum levels of fluconazole were within the t herapeutic range during the entire dosage interval. Follow up showed m icrobiological and clinical cure in all patients with no side-effects. In one patient a dosage of 4 mg/kg per day lead to a microbiological relapse with sub-therapeutic serum levels. Conclusions Oral fluconazol e seems to be a safe and effective treatment for Candida albicans sept icaemia even in premature infants.