Objective and Aim: Invasive fungal infection (IFI) in very low birth weight (VLBW, ≤1500g) infants is related to significant morbidity and mortality. To compare two fluconazole prophylaxis regimens for IFI in VLBW while maintaining surveillance for fluconazole resistance. \\r\\nMaterial and Methods: All VLBW infants hospitalized in the neonatal intensive care unit (NICU) were enrolled as the study group if they were less than 1 day old . Infants who received targeted fluconazole prophylaxis between September 2011-August 2012 were compared with the ones who received standard fluconazole prophylaxis between September 2012- August 2013. Intravenous (IV) or oral fluconazole, 3mg/kg, twice weekly for 30 days to very low birth weight (VLBW) and 45 days to extremely low birth weight (ELBW) infants were given as standard prophylaxis. VLBW infants who had predefined risk factors received fluconazole at the same dosage, constituted the targeted prophylaxis group. \\r\\nResults: Fifty one patients were allocated as the standard fluconazole prophylaxis group and 67 patients were enrolled for the targeted fluconazole prophylaxis group. There existed no IFI in the standard fluconazole prophylaxis group. However, 4 (5.9%) patients had IFI in the targeted fluconazole prophylaxis group. No adverse effects of fluconazole were recognized. Additionally, there were no deaths in patients with IFI. \\r\\nConclusion: Standard prophylaxis prevents IFI without increasing the resistivity pattern in our NICU setting.

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