Document Detail


The effect of prophylactic ointment therapy on nosocomial sepsis rates and skin integrity in infants with birth weights of 501 to 1000 g.
MedLine Citation:
PMID:  15121929     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
William H Edwards; Jeanette M Conner; Roger F Soll;
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Publication Detail:
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:
Title:  Pediatrics     Volume:  113     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-05-03     Completed Date:  2004-08-09     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1195-203     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, Children's Hospital at Dartmouth, Lebanon, New Hampshire 03756, USA. william.h.edwards@hitchcock.org
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MeSH Terms
Descriptor/Qualifier:
Cross Infection / 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:
M01 RR109/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Ointments

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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