Borderon J C
Pediatrie. 1986 Mar;41(2):169-73.
After having decided to treat a neonate with antibiotics, two important topics are knowledge of its nature and surveillance of treatment. Infections of mother origin remain sensitive to the association ampicillin-aminoglycoside, except if the mother had received ampicillin. Nosocomial infections are due to more resistant agents; the nature of antibiotics to treat them depends upon local immunological status. It is necessary to associate an aminoglycoside to ampicillin against E. coli; this association permits a faster bactericidal effect than ampicillin alone, therefore seems better in the beginning of treatment. New antibiotics have improved our therapeutic possibilities; however it is obvious that new cephalosporins are inactive against Listeria. Antimicrobial therapy must be adapted both qualitatively and quantitatively, to obtain a treatment with low toxicity and good efficiency.
决定用抗生素治疗新生儿后，有两个重要的问题，一是了解感染的性质，二是监测治疗情况。源于母亲的感染对氨苄西林-氨基糖苷类药物联合治疗仍敏感，除非母亲曾接受过氨苄西林治疗。医院感染由耐药性更强的病原体引起；治疗这些感染所用抗生素的种类取决于当地的免疫状况。针对大肠杆菌感染，有必要将氨基糖苷类药物与氨苄西林联合使用；这种联合用药比单独使用氨苄西林具有更快的杀菌效果，因此在治疗初期似乎更好。新型抗生素拓宽了我们的治疗选择；然而，很明显新型头孢菌素对李斯特菌无活性。抗菌治疗必须在质量和数量上进行调整，以实现低毒性和高效的治疗效果。
