| The effect of prophylactic ointment therapy on nosocomial sepsis rates and skin integrity in infants with birth weights of 501 to 1000 g. | |
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MedLine Citation:
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PMID: 15121929 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Extremely low birth weight infants have a high risk of developing nosocomial bacterial sepsis (NBS). Immature fragile skin may represent an inadequate protective barrier to bacteria colonizing the skin. We conducted a randomized, multicenter trial to determine whether prophylactic application of an emollient ointment would result in a lower incidence of death and/or NBS in the first 28 days of life, compared with routine skin care. METHODS: Infants of birth weight 501 to 1000 g and gestational age < or =30 weeks were assigned randomly to receive generalized application of ointment twice a day through day 14 (prophylactic group [P]) or local application of ointment to the site of injury (routine skin care [R]). The study was conducted at 53 neonatal intensive care units that were members of the Vermont Oxford Network. RESULTS: Included in the analysis were 1191 infants (P: 602; R: 589). No difference was found in the combined primary outcome of NBS or death (33.6% P vs 30.3% R; relative risk [RR]: 1.10; 95% confidence interval [CI]: 0.89, 1.27). The incidence of death was no different between the groups (10.8% P vs 12.1% R; RR: 0.87; 95% CI: 0.59, 1.25). More infants in the prophylactic group had NBS (25.8% P vs 20.4% R; RR: 1.26; 95% CI: 1.02, 1.54), predominantly in the lower birth weight infants (501-750 g) and for infections caused by coagulase-negative staphylococci. Infants in the prophylactic group had better skin condition on days 1 to 14 of life and less skin injury on days 15 to 28 of life. There was no difference between groups in other complications of prematurity. CONCLUSIONS: Prophylactic application of ointment did not lead to a difference in death and/or NBS in the first 28 days of life. There may be an increase in the risk of NBS associated with this practice. |
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Authors:
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William H Edwards; Jeanette M Conner; Roger F Soll; |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Pediatrics Volume: 113 ISSN: 1098-4275 ISO Abbreviation: Pediatrics Publication Date: 2004 May |
Date Detail:
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Created Date: 2004-05-03 Completed Date: 2004-08-09 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 0376422 Medline TA: Pediatrics Country: United States |
Other Details:
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Languages: eng Pagination: 1195-203 Citation Subset: AIM; IM |
Affiliation:
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Department of Pediatrics, Children's Hospital at Dartmouth, Lebanon, New Hampshire 03756, USA. william.h.edwards@hitchcock.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Cross Infection
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epidemiology,
prevention & control* Female Humans Infant, Newborn Infant, Premature Infant, Premature, Diseases / epidemiology, prevention & control* Infant, Very Low Birth Weight* Male Ointments / therapeutic use* Sepsis / epidemiology, prevention & control* Skin Care* Skin Physiological Phenomena |
| Grant Support | |
ID/Acronym/Agency:
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M01 RR109/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Ointments |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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