Starr S E
J Pediatr. 1985 Jun;106(6):1043-8. doi: 10.1016/s0022-3476(85)80266-3.
Septicemia continues to be an important cause of neonatal morbidity and mortality. The bacteria most commonly responsible are group B beta-hemolytic streptococci and Escherichia coli, but regional differences exist. Recently sepsis caused by Staphylococcus epidermidis has occurred with increasing frequency in several neonatal intensive care units. Other organisms are less commonly responsible. The choice of antibiotics for suspected sepsis is based on the possible organisms involved and their antibiotic susceptibility patterns, which vary from hospital to hospital and at different times in the same hospital. Currently recommended initial therapy consists of a penicillin and an aminoglycoside, usually ampicillin and gentamicin. The addition of vancomycin is indicated when staphylococcal septicemia is suspected. During outbreaks of neonatal sepsis caused by aminoglycoside-resistant gram-negative bacteria, the use of third-generation cephalosporins or acylaminopenicillins may be appropriate, depending on the results of susceptibility tests. Continuing efforts to develop antibiotics for the treatment of neonatal sepsis are warranted.
败血症仍然是新生儿发病和死亡的重要原因。最常见的致病菌是B族β溶血性链球菌和大肠杆菌，但存在地区差异。最近，表皮葡萄球菌引起的败血症在几个新生儿重症监护病房中出现的频率越来越高。其他病原体致病的情况较少见。对于疑似败血症的抗生素选择基于可能涉及的病原体及其抗生素敏感性模式，这些模式在不同医院以及同一医院的不同时间有所不同。目前推荐的初始治疗方案包括一种青霉素和一种氨基糖苷类药物，通常是氨苄西林和庆大霉素。怀疑有葡萄球菌败血症时需加用万古霉素。在由耐氨基糖苷类革兰氏阴性菌引起的新生儿败血症暴发期间，根据药敏试验结果，使用第三代头孢菌素或酰氨基青霉素可能是合适的。继续努力研发治疗新生儿败血症的抗生素是有必要的。
