Fluconazole Use Doesn't Up Risk of Stillbirth, Neonatal Death

In continuation of my update on Fluconazole

Fluconazole use in pregnancy seems not to be associated with significantly increased risks of stillbirth or neonatal death, according to a research letter published in the June 12 issue of the Journal of the American Medical Association.

Björn Pasternak, M.D., Ph.D., from the Karolinska Institutet in Stockholm, and colleagues examined whether fluconazole use during pregnancy is associated with stillbirth and neonatal death. The authors used nationwide register data to identify all pregnancies with singleton live births and stillbirths in Sweden and Norway. A total of 10,669 exposed and 106,690 unexposed pregnancies from a cohort of 1,485,316 pregnancies were included in the matched analysis of stillbirth, and 10,640 exposed and 106,387 unexposed pregnancies were included in the matched analysis of neonatal death.

The researchers found that there were 2.7 and 3.6 stillbirths per 1,000 exposed and unexposed pregnancies, respectively (hazard ratio, 0.76; 95 percent confidence interval, 0.52 to 1.1) and 1.2 and 1.7 neonatal deaths per 1,000 exposed and unexposed pregnancies, respectively (risk ratio, 0.73; 95 percent confidence interval, 0.42 to 1.29). Similar results were seen for doses of 300 mg or less and more than 300 mg.

"Although the data on fluconazole use in pregnancy suggest no increased risk of stillbirth, additional studies should be conducted and the collective body of data scrutinized by drug authorities before recommendations to guide clinical decision making are made, and weighed against the benefits of therapy," the authors write.

The Antidepressant Sertraline Provides a Promising Therapeutic Option for Neurotropic Cryptococcal Infections

New research conducted by biologists at Texas A&M University suggests that sertraline (see structure below, ZOLOFT®), one of the most widely prescribed antidepressants in the world, also packs a potential preventative bonus  potent mechanisms capable of inhibiting deadly fungal infections. 

C. neoformans is a potentially dangerous fungal pathogen found in many soils throughout the world that may cause systemic infections, particularly involving the central nervous system. In most cases, the microscopic, airborne fungal cells of C. neoformans cause asymptomatic colonization in the lungs. However, Lin says the fungus is particularly aggressive in people with weakened immune systems and can spread to other parts of the body, such as the brain and spinal cord, resulting in cryptococcal meningitis  a condition that, in absence of treatment, is fatal.