Neonatal infection: antibiotics for prevention and treatment

  • NICE guideline
  • NG195
  • Published: 
  • Last updated: 
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Antifungals to prevent fungal infection during antibiotic treatment for late-onset neonatal infection

1.26 When to give antifungals

1.26.1

Give prophylactic oral nystatin to babies treated with antibiotics for suspected late-onset neonatal bacterial infection if they:

  • have a birthweight of up to 1,500 g or

  • were born at less than 30 weeks' gestation.

    If oral administration of nystatin is not possible, give intravenous fluconazole. In April 2021, this was an off-label use of fluconazole. See NICE's information on prescribing medicines and use clinical judgement to determine the dosage. [2021]

For a short explanation of why the committee made this recommendation and how it might affect practice, see the rationale and impact section on antifungals to prevent fungal infection during antibiotic treatment for late-onset neonatal infection.

Full details of the evidence and the committee's discussion are in evidence review I: antifungal prophylaxis for treating late-onset neonatal infection.