The Ohio State University, Columbus, OH, USA.
Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA.
J Perinatol. 2023 Sep;43(9):1145-1151. doi: 10.1038/s41372-023-01720-6. Epub 2023 Jul 12.
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.
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.
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.
Adherence to the 5-day definitive antibiotic treatment for "culture-negative" pneumonia was high and the intervention seemed safe.
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。
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。
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。
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。
