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Surgery Today
Published in: Surgery Today 4/2021

01-04-2021 | Original Article

Prophylactic efficacy of enteral antifungal administration of miconazole for intestinal perforation, especially for necrotizing enterocolitis: a historical cohort study at a single institution

Authors: Motofumi Torikai, Koshiro Sugita, Satoshi Ibara, Chie Ishihara, Masaya Kibe, Kenichi Murakami, Shin Shinyama, Motoi Mukai, Takamasa Ikee, Kazunobu Sueyoshi, Hiroyuki Noguchi, Satoshi Ieiri

Published in: Surgery Today | Issue 4/2021

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Abstract

Purpose

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.

Methods

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.

Results

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 < 0.05).

Conclusions

The efficacy of the enteral administration of MCZ on intestinal perforation with NEC highlights a new prophylactic concept in the clinical management of ELBWIs.
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Metadata
Title
Prophylactic efficacy of enteral antifungal administration of miconazole for intestinal perforation, especially for necrotizing enterocolitis: a historical cohort study at a single institution
Authors
Motofumi Torikai
Koshiro Sugita
Satoshi Ibara
Chie Ishihara
Masaya Kibe
Kenichi Murakami
Shin Shinyama
Motoi Mukai
Takamasa Ikee
Kazunobu Sueyoshi
Hiroyuki Noguchi
Satoshi Ieiri
Publication date
01-04-2021
Publisher
Springer Singapore
Published in
Surgery Today / Issue 4/2021
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-020-02125-0

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