We use a low dose Fluconazole protocol to reduce systemic fungal infection in VLBW babies less than 1000 gms. Low dose Fluconazole is given for a total of six weeks. The dose is adjusted according to weight q 2 wks. So the dose stays the same for the first 2 weeks, then it's adjusted on the 3rd week and again on the 5th week. We have significantly reduced systemic fungal infctions with this protocol. If the baby does become septic, the infection is treated with a full course of Fluconazole or Abelcet and the protocol is resume subtracting the weeks used for treatment. So if baby becomes infected the start of 3rd week of the protocol and you treat for 2 weeks, then you would resume the protocol at the 5th week. We trialed a type IVIG(Immunoglobulin) as a prophylaxis for bacterial infection but we found no difference in the amount of infections. So, presently we do not have a protocol for prevention bacteria sepsis.
