Knoderer Chad A, Kaylor David M, Toth Meghan E, Malloy Katherine M, Nichols Kristen R
J Pediatr Pharmacol Ther. 2018 May-Jun;23(3):209-214. doi: 10.5863/1551-6776-23.3.209.
The objective of this study was to characterize clinical outcomes when cefepime was used in a neonatal intensive care population.
Data were extracted from the medical records of all full-term (40 weeks gestational age) patients up to 2 months of age and preterm patients up to 48 weeks postmenstrual age admitted to the neonatal intensive care unit (NICU) at a freestanding children's hospital between January 1, 2010, and December 31, 2013, who received at least 48 hours of cefepime. The primary outcome measure was a positive clinical response as defined by a normalization of white blood cell count and/or culture clearance.
Final analysis included 74 patients. Clinical response was evaluable in 43.2% (32 of 74) of courses. Of these, positive clinical response was observed in 81.3% (26 of 32). Overall patient mortality was 16.2% (12 of 74). Adverse effects (AEs) occurred in 14.9% (11 of 74) of courses.
Cefepime can be used safely with reasonable clinical response in a NICU population, but additional studies are needed to further determine cefepime-associated clinical outcomes.
本研究的目的是描述头孢吡肟用于新生儿重症监护人群时的临床结局。
从一家独立儿童医院的新生儿重症监护病房（NICU）在2010年1月1日至2013年12月31日期间收治的所有足月儿（胎龄40周）至2个月龄以及早产儿至孕龄后48周且接受至少48小时头孢吡肟治疗的患者病历中提取数据。主要结局指标是根据白细胞计数正常化和/或培养物清除定义的阳性临床反应。
最终分析纳入74例患者。43.2%（74例中的32例）疗程的临床反应可评估。其中，81.3%（32例中的26例）观察到阳性临床反应。总体患者死亡率为16.2%（74例中的12例）。14.9%（74例中的11例）疗程出现不良反应（AE）。
在新生儿重症监护人群中，头孢吡肟可安全使用并伴有合理的临床反应，但需要进一步研究以进一步确定与头孢吡肟相关的临床结局。
