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Triazole Antifungal — Candida / Fungal Prophylaxis in Preterm Neonates

Fluconazole (Paediatric)

Brand names: Diflucan

Paediatric use of fluconazole, a triazole antifungal, for candidal and other susceptible fungal infections including mucosal candidiasis and cryptococcal disease in children and neonates.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

Inhibits fungal cytochrome P450-dependent 14-alpha-demethylase, blocking conversion of lanosterol to ergosterol and disrupting fungal cell membrane integrity.

Prescribing in practice

  • Dosing in children and neonates differs markedly by age and renal function and must be confirmed against a children's formulary; neonatal clearance is prolonged so dosing intervals are extended.
  • It is a potent enzyme inhibitor (notably CYP2C9 and CYP3A4) and prolongs the QT interval, so review concurrent medicines for interaction and arrhythmia risk.
  • Adjust dosing in renal impairment and monitor liver function with prolonged or higher-dose courses.

Monitoring

Monitor liver function during prolonged therapy and assess renal function, with ECG consideration where additional QT-prolonging factors or drugs are present.

Counselling the patient

  • Tell the team about any other medicines, as fluconazole interacts with many drugs.
  • Report jaundice, dark urine, persistent nausea or rash to a clinician.
  • Complete the full prescribed course even once the child feels better.

Evidence & guidelines

Fluconazole is an established antifungal supported by SPC and paediatric infectious disease guidance for candidal and cryptococcal infection.

Reference: ESCMID Candida Guidelines; BPNG Neonatal Antifungal Guidelines; NICE Preterm Birth Guidance NG25; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.