极低出生体重儿晚期新生儿败血症抗生素的选择

Choice of antibiotics in late neonatal sepsis in the extremely low birth weight infant.

作者信息

Allen Tara R, da Silva Orlando P

机构信息

Joseph's Health Care London, Department of Paediatrics, Child Health Research Institute, University of Western Ontario, London, Ontario.

出版信息

Can J Infect Dis. 2003 Jan;14(1):28-31. doi: 10.1155/2003/510265.

DOI:10.1155/2003/510265

PMID:18159422

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2094899/

Abstract

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.

摘要

目的

回顾新生儿重症监护病房中体重1000克及以下婴儿疑似晚发型新生儿败血症的抗生素选择。

方法

对病历进行回顾性研究。

结果

在研究期间，96名体重1000克及以下的婴儿入住新生儿重症监护病房。62名婴儿存活超过出生后4天，并且至少进行了一次败血症检查以排除晚发型新生儿感染。在这62名研究患者中，42名（68%）开始使用氨苄西林和奈替米星（A/N），20名（32%）开始使用万古霉素和头孢唑肟（V/C）作为首选抗生素，等待培养结果。在开始使用A/N的患者中，42名中有17名血培养呈阳性，而在使用V/C的20名患者中有11名血培养呈阳性（40%对55%，P = 0.40）。开始使用A/N的婴儿平均（±标准差）出生体重为793±133克，而接受V/C的组平均出生体重为728±153克（P = 0.09）。A/N组有7名患者死亡，V/C组有3名患者死亡（16.7%对15%，P = 0.84）。除了所研究的败血症发作外，在出院前，A/N组42名婴儿中有21名（50%）因疑似败血症进行了进一步检查，而最初使用V/C的20名婴儿中有16名（80%）进行了进一步检查（P = 0.048）。