Purpose of review: This review focuses on recent data regarding antifungal prophylaxis and antifungal treatment of neonatal candidiasis.
Recent findings: Candida species are the leading cause of invasive fungal infection in the neonatal intensive care unit, and are the third most common blood culture isolates recovered from cases of late-onset sepsis in the neonatal intensive care unit. Neonatal candidemia is associated with significant morbidity and mortality. Risk factors for neonatal candidiasis have been elucidated, and prophylaxis of high-risk infants has been found to be effective, particularly in neonatal intensive care units with a high incidence of candidemia. Amphotericin B has been the mainstay of antifungal therapy for candidemia in the neonatal intensive care unit but newer agents such as echinocandins and azoles are currently being evaluated.
Summary: Neonatal candidiasis is a serious infection especially in extremely low-birthweight infants and prophylaxis has been shown to be effective in preventing candidiasis in high-risk infants. Newer pharmacokinetic, safety and efficacy data for both older and newer antifungal agents are emerging in neonates, and these data may help us achieve more effective management of neonatal candidiasis.