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Ampicillin versus penicillin in the empiric therapy of ELBW neonates at risk of early onset sepsis.
MedLine Citation:
PMID:  21895866     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background:  There are no comparative data on the impact of different empiric antibiotic regimens on early bowel colonization as well as on clinical efficacy in extremely low birth weight (ELBW) neonates at risk of early onset sepsis (EOS). Methods:  We performed a subgroup analysis of ELBW neonates recruited into a two-center, prospective, cluster randomized study comparing ampicillin and penicillin both combined with gentamicin, within the first 72h of life. A composite primary end-point (need for change of antibiotics within 72 h and/or 7 day all cause mortality) and colonization rate and duration by opportunistic aerobic microorganisms was assessed by hierarchical models corrected for study center and period. Results:  In ampicillin (n = 36) and penicillin (n = 39) groups change of antibiotics, 7 day mortality and the composite endpoint occurred at similar rates. NICU mortality of infants with gestational age below 26 weeks was lower in ampicillin group. Ampicillin treatment was associated with higher colonization rate with K. pneumoniae including ampicillin resistant strains. Conclusion:  Preliminary data indicate an urgent need for adequately powered studies of early antibiotic therapy in the subpopulation of ELBW neonates at risk of EOS.
Authors:
T Metsvaht; M-L Ilmoja; U Parm; M Merila; L Maipuu; P Müürsepp; K Julge; E Sepp; I Lutsar
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-5
Journal Detail:
Title:  Pediatrics international : official journal of the Japan Pediatric Society     Volume:  -     ISSN:  1442-200X     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100886002     Medline TA:  Pediatr Int     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 The Authors. Pediatrics International © 2011 Japan Pediatric Society.
Affiliation:
Pediatric and Neonatal Intensive Care, Tartu University Clinics, Tartu, Pediatric Intensive Care, Tallinn Children's Hospital, Tallinn, Institute of Microbiology, Tartu University, Department of Pediatrics, Tartu University Clinics, Tartu, Estonia.
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