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Pediatric Surgery International
Published in: Pediatric Surgery International 1/2023

01-12-2023 | Original Article

Does protocol miconazole administration improve mortality and morbidity on surgical necrotizing enterocolitis?

Authors: Koshiro Sugita, Mitsuru Muto, Masakazu Murakami, Keisuke Yano, Toshio Harumatsu, Shun Onishi, Koji Yamada, Waka Yamada, Makoto Matsukubo, Takafumi Kawano, Seiro Machigashira, Motofumi Torikai, Chie Ishihara, Takuya Tokuhisa, Satoshi Ibara, Satoshi Ieiri

Published in: Pediatric Surgery International | Issue 1/2023

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Abstract

Purpose

Our previous clinical pilot study reported that miconazole (MCZ) prevented morbidity from surgical necrotizing enterocolitis (NEC). The present study re-investigated this effect in a long-term cohort over 20 years.

Methods

We conducted a retrospective cohort study from April 1998 to March 2020. A total of 1169 extremely low-birth-weight infants (ELBWIs) admitted to our neonatal intensive care unit, including 45 with NEC (3.8%), underwent surgery. Since 2002, protocol MCZ administration for 3 weeks has been applied for neonates born before 26 weeks’ gestation or weighing under 1000 g. We compared the background characteristics and clinical outcomes between patients with and without MCZ administration.

Results

The morbidity rate decreased after applying the MCZ protocol, but no improvement in mortality was seen. A propensity score-matched analysis indicated that treated patients by MCZ showed a delay in developing surgical NEC by 12 days. The MCZ protocol also helped increase body weight at surgery. Prophylactic MCZ administration did not improve the neurological development of the language–social and postural–motor domains in the surgical NEC patients. But cognitive–adaptive domain caught up by a chronological age of 3 years old.

Conclusions

Revising the protocol to extend the dosing period may improve the outcomes of surgical NEC after the onset.
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Metadata
Title
Does protocol miconazole administration improve mortality and morbidity on surgical necrotizing enterocolitis?
Authors
Koshiro Sugita
Mitsuru Muto
Masakazu Murakami
Keisuke Yano
Toshio Harumatsu
Shun Onishi
Koji Yamada
Waka Yamada
Makoto Matsukubo
Takafumi Kawano
Seiro Machigashira
Motofumi Torikai
Chie Ishihara
Takuya Tokuhisa
Satoshi Ibara
Satoshi Ieiri
Publication date
01-12-2023
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Surgery International / Issue 1/2023
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-023-05390-5

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