| Objective: To observe curative effect of the oral fluconazole for preven-tion, treatment in children with acute leukemia complicated with fungal infection. And observation of adverse reactions and safety of fluconazole.Methods: There are a total of 104 childrens of acute leukemia (induc- tion treatment, maintenance treatment, high-dose methotrexate, early intensive, and intensive therapy and intensificaiton chemotherapy, in the time of maintainable remission)whose peripheral blood neutrophils is less than the absolute value of 1.0×109/L, whom lived in our hospital for the diagnosis of pediatric acute leukemia during 1997.10-2008.11 .To make 60 cases as the treatment group,take oral fluconazole to prevent, preventive dosage for 3-6mg/kg, the maximum is less than 200mg, lasting about 1-2 weeks. 44 cases as the control group. without preventive oral fluconazole,after diagnosing infection that caused by the merger fungal, take oral or intravenous fluconazole, the dosage is 6-12mg/kg as the control group,the period of treatment relies on patient's condition. To observe the differences in two groups of rates of acute leukemia with the merger fungal infec- tion,and the differences of adverse reaction in elevated ALT liver function, renal BUN, CR, and nausea, vomiting, reduced appetite, and so on for gastrointestinal symptom. Meantime to observe the differences in nosocomial infection, length of hospital stay, fever days, kinds and times of antibiotic,and reduction of peripheral blood of each group in absolute neutrophils (ANC).Results: There was 1 case of the merger fungal infection in the treatment group,infection rate was 1.67 percent,and 6 cases in the control group, infection rate was 13.64%.There was significant difference in merger fungal infection between the treatment group and the control group (X2=5.601,P<0.05); There were 35 cases of nosocomial infection in treat- ment group,infection rate was 58.33 %,and 34 cases in the control group, infection rate was 77.27%. The statistical significance of the differences of nosocomial infection rate in two datas is X2=4.163, P<0.05; The average days of fever was5.49±2.59 in treatment group,and 6.84±2.93 in control gtoup.There is statistical significant difference (U=398.50, P<0.05); The average days of hospitalization is 24.22±10.50 in treatment group ,and 32.07±24.30 in control group. There is no statistical significance, (U=1111.5,P>0.05):During the period of chemotherapy, Absolute value of peripheral blood neutrophils (ANC) <0.5×10~9/L in every group account most,there were 48 cases of ANC<0.5×10~9/L in treatment group,and 12cases of ANC> 0.5×10~9/L,it had statistical significance of the differences, X2=66.375, P<0.01.And 30 cases of ANC<0.5×10~9/L in control group,14 cases of ANC>0.5×10~9/L, there was statistical significance of the differences, X2=9.782, P<0.01. Antibiotics were used in both group,one kind of antibiotic was used 6 times(11.11%) in treatment group,and 13 times (35.14%)in control group, here was statistical significance of the differences, X2=8.193, P<0.01.There were vering degrees of adverse reaction during the treatment period. Adverse reaction in treatment group: there are 23 cases of elevated the liver function GPT ,the rate is 38.33%;4 cases of elevated Renal BUN,CR,the rate is 6.67%,52 cases of gastroin- testinal reaction ,the rate is 86.67%. Adverse reaction in control group: there are 16 cases of elevated the liver function GPT, the rate is 36.36%;3 cases of elevated Renal BUN,the rate is 6.82%,39 cases of gastrointestinal reaction ,the rate is 88.64%. The diffrence of adverse reactions in two groups is no statistical significance.(P>0.05).There was no serious adverse reactions during fluconazole treatment. Acute leukemia in children with oral cavity, fungal infection in the digestive tract is hackneyed, but the rates of fungal mascclinew is low. Conclusion:1. Oral fluconazole therapy can prevent complicating with fungal infection from children with acute leukemia .2. Oral fluconazole therapy is safety with little adverse reactions.
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