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[新庆大霉素给药指南下的两例新生儿脑膜炎病例]

[Two cases of neonatal meningitis after new gentamicin dosing guidelines].

作者信息

Blaabjerg Anne Sofie, Fenger-Grøn Jesper, Møller Jens Kjølseth, Kofoed Poul Erik Lund

出版信息

Ugeskr Laeger. 2016 Apr 4;178(14):V12151001.

Abstract

Neonates with suspected or proven sepsis are treated with ampicillin and until recently with 5 mg gentamicin/kg every 24 h. New guidelines recommend the same gentamicin dose, but with longer intervals depending on gestational age. Two neonates receiving gentamicin every 48 h improved initially, but both deteriorated again before the second dose. In both infants ampicillin-resistant but gentamicin-sensitive Escherichia coli was found. In one of the infants a resistant/less sensitive E. coli strain was also found in the cerebrospinal fluid. The rationale for the new dosing guidelines is discussed.

摘要

疑似或确诊败血症的新生儿接受氨苄西林治疗,直到最近一直是每24小时给予5毫克庆大霉素/千克。新指南推荐相同的庆大霉素剂量,但给药间隔根据胎龄延长。两名每48小时接受一次庆大霉素治疗的新生儿最初病情有所改善,但在第二次给药前病情再次恶化。在这两名婴儿中均发现了对氨苄西林耐药但对庆大霉素敏感的大肠杆菌。在其中一名婴儿的脑脊液中还发现了一种耐药/敏感性较低的大肠杆菌菌株。文中讨论了新给药指南的理论依据。

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