Prophylactic efficacy of enteral antifungal administration of miconazole for intestinal perforation, especially for necrotizing enterocolitis: a historical cohort study at a single institution
Autor: | Motofumi Torikai, Chie Ishihara, Satoshi Ieiri, Koshiro Sugita, Satoshi Ibara, Kazunobu Sueyoshi, Motoi Mukai, Shin Shinyama, Takamasa Ikee, Hiroyuki Noguchi, Masaya Kibe, Kenichi Murakami |
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Rok vydání: | 2020 |
Předmět: |
Male
medicine.medical_specialty Antifungal Agents Time Factors Miconazole Perforation (oil well) Administration Oral Enteral administration Gastroenterology Cohort Studies 03 medical and health sciences 0302 clinical medicine Surgical oncology Enterocolitis Necrotizing Intensive care Internal medicine Medicine Humans business.industry Incidence (epidemiology) Infant Newborn General Medicine Odds ratio medicine.disease Mycoses Infant Extremely Low Birth Weight Intestinal Perforation 030220 oncology & carcinogenesis Necrotizing enterocolitis 030211 gastroenterology & hepatology Surgery Female business medicine.drug |
Zdroj: | Surgery today. 51(4) |
ISSN: | 1436-2813 |
Popis: | Despite improvements in neonatal intensive care, the outcomes of extremely-low-birth-weight infants (ELBWIs) with surgical diseases remain to be improved. We started administering enteral miconazole (MCZ) to ELBWIs from 2002 to prevent fungal infection. Since then, the incidence of intestinal perforation has significantly decreased. We investigated this prophylactic effect of MCZ against necrotizing enterocolitis (NEC) and focal intestinal perforation (FIP) and explored a new prophylactic concept against intestinal perforation. We designed a historical cohort study to evaluate the effect of MCZ for intestinal perforation in ELBWIs who underwent treatment in our neonatal intensive-care unit between January 1998 and December 2005. We divided these cases into two groups: the Pre-MCZ group and the Post-MCZ group. We compared the morbidity, clinical outcomes and pathological features of NEC and FIP. The rate of intestinal perforation with NEC was significantly reduced after the introduction of MCZ (p = 0.007, odds ratio; 3.782, 95% confidence interval; 1.368–12.08). The pathological findings of NEC specimens showed that the accumulation of inflammatory cells was significantly reduced in the Post-MCZ group when compared with the Pre-MCZ group (p |
Databáze: | OpenAIRE |
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