Table 2.
Influence of nine factors in the decision whether or not to prescribe prophylactic fluconazole
| Rationale for practice | Use fluconazole prophylaxis (n = 99), n (%) | Do not use prophylaxis (n = 86), n (%) | Number of available data | p values | ||
|---|---|---|---|---|---|---|
| Likert ≤ 3 | Likert ≥ 4 | Likert ≤ 3 | Likert ≥ 4 | |||
| Incidence of candidiasis in your NICU is/is not high enough to justify prophylaxis | 55 (59) | 39 (41) | 17 (21) | 64 (79) | 181 | <0.0001 |
| Widespread antifungal use could lead to increased antifungal resistance | 48 (51) | 46 (49) | 25 (32) | 54 (68) | 178 | 0.01 |
| Statement by paediatric societies in support of routine use in a subset of newborns is needed | 53 (60) | 36 (40) | 35 (44) | 44 (56) | 174 | 0.048 |
| The criteria of high-risk patients in whom prophylaxis should be attempted need clarification | 40 (60) | 27 (40) | 37 (46) | 44 (54) | 179 | 0.23 |
| The agent is too costly | 89 (96) | 4 (4) | 74 (94) | 5 (6) | 178 | 0.73 |
| The role of surveillance culture in identifying high-risk neonates needs clarification | 50 (55) | 41 (45) | 39 (48) | 42 (52) | 177 | 0.37 |
| Uncertainty about pharmacometrics of the antifungal agent in the newborn is great | 62 (67) | 31 (33) | 48 (60) | 32 (40) | 178 | 0.36 |
| Uncertainty about safety of the antifungal agent in the newborn is great | 67 (73) | 25 (27) | 53 (65) | 28 (35) | 178 | 0.29 |
| Additional studies of efficacy of the antifungal agent in the perinatal population are needed | 41 (43) | 54 (57) | 29 (36) | 52 (64) | 181 | 0.32 |