新生儿重症监护病房肺炎的短程抗生素治疗。
Short-course antibiotic therapy for pneumonia in the neonatal intensive care unit.
机构信息
The Ohio State University, Columbus, OH, USA.
Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA.
出版信息
J Perinatol. 2023 Sep;43(9):1145-1151. doi: 10.1038/s41372-023-01720-6. Epub 2023 Jul 12.
OBJECTIVE
To determine the adherence and safety outcomes of a 5-day antibiotic course with a "time-out" for treatment of "blood culture-negative" pneumonia in the NICU.
STUDY DESIGN
Prospective surveillance of all infants diagnosed with pneumonia at 7 NICUs from 8/2020-12/2021. Safety outcomes were defined a priori by re-initiation of antibiotic therapy within 14 days after discontinuation and overall and sepsis-related mortality.
RESULTS
128 infants were diagnosed with 136 episodes of pneumonia; 88% (n = 119) were treated with 5 days of definitive antibiotic therapy. Antibiotics were restarted within 14 days in 22 (16%) of the 136 pneumonia episodes. However, only 3 (3%) of the 119 episodes of pneumonia treated for 5 days had antibiotics restarted for pneumonia. Mortality was 5% (7/128); 5 of the 7 deaths were assessed as sepsis-related.
CONCLUSION
Adherence to the 5-day definitive antibiotic treatment for "culture-negative" pneumonia was high and the intervention seemed safe.
目的
确定在新生儿重症监护病房（NICU）中，对于“血培养阴性”肺炎采用 5 天抗生素疗程并“暂停”治疗的依从性和安全性结果。
研究设计
对 2020 年 8 月至 2021 年 12 月期间，8 个 NICU 中所有被诊断患有肺炎的婴儿进行前瞻性监测。安全性结果通过抗生素停药后 14 天内重新开始治疗以及总死亡率和脓毒症相关死亡率预先定义。
结果
128 名婴儿被诊断患有 136 次肺炎发作；88%（n=119）接受了 5 天的确定性抗生素治疗。在 136 次肺炎发作中，有 22 次（16%）在 14 天内重新开始使用抗生素。然而，仅在接受 5 天治疗的 119 次肺炎发作中有 3 次（3%）因肺炎重新开始使用抗生素。死亡率为 5%（7/128）；7 例死亡中有 5 例被评估为与脓毒症相关。
结论
对于“培养阴性”肺炎的 5 天确定性抗生素治疗的依从性很高，该干预措施似乎是安全的。
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