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Choice of antibiotics in late neonatal sepsis in the extremely low birth weight infant.
MedLine Citation:
PMID:  18159422     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To review the choice of antibiotics in treating suspected late neonatal sepsis in infants weighing 1000 g or less in a neonatal intensive care unit.
METHODS: Retrospective review of medical records.
RESULTS: Ninety-six infants weighing 1000 g or less were admitted to the neonatal intensive care unit during the study period. Sixty-two infants survived beyond four days of life and had at least one sepsis workup done to exclude late neonatal infection. Of the 62 study patients, 42 (68%) were started on ampicillin and netilmicin (A/N) and 20 (32%) were started on vancomycin and ceftizoxime (V/C) as the antibiotics of choice, pending culture results. Of the patients started on A/N, 17 of 42 had a positive blood culture compared with 11 of 20 on V/C (40% versus 55%, P=0.40). The mean (+/-SD) birth weight of infants started on A/N was 793+/-133 g compared with a mean of 728+/-153 g in the group that received V/C (P=0.09). Seven patients died in the A/N group compared with three in the V/C group (16.7% versus 15%, P=0.84). In addition to the sepsis episode studied, before they were discharged from hospital, 21 of 42 (50%) infants in the A/N group had further workups for suspected sepsis, compared with 16 of 20 (80%) (P=0.048) infants initially given V/C.
CONCLUSIONS: Ampicillin and netilmicin is a safe antibiotic combination for neonates suspected of late sepsis. This, in turn, may be important in reducing vancomycin overuse and the potential for bacterial resistance to this antimicrobial agent.
Authors:
Tara R Allen; Orlando P da Silva
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Canadian journal of infectious diseases = Journal canadien des maladies infectieuses     Volume:  14     ISSN:  1180-2332     ISO Abbreviation:  Can J Infect Dis     Publication Date:  2003 Jan 
Date Detail:
Created Date:  2007-12-26     Completed Date:  2011-07-14     Revised Date:  2013-05-23    
Medline Journal Info:
Nlm Unique ID:  9425856     Medline TA:  Can J Infect Dis     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  28-31     Citation Subset:  -    
Affiliation:
Joseph's Health Care London, Department of Paediatrics, Child Health Research Institute, University of Western Ontario, London, Ontario.
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