Marget W, Belohradsky B H, Roos R
Infection. 1980;Suppl 1:82-6. doi: 10.1007/BF01644941.
The chemotherapy of septicaemia in newborns differs fundamentally from that in older children or adults because, although newborns have a fully developed immunological system, the system has not yet "learned" to operate completely. Ultimately, optimal chemotherapy can only be found empirically. In this respect a few basic guidelines can be given however: 1. The initial therapy must bring the pathogen under control with a high degree of certainty, since a correction in therapy following pathogen indentification is usually too late. 2. Since the pharmacokinetics of antibiotics in newborns vary considerably, the minimal peak serum concentration observed should exceed the MIC of the pathogen. 3. In rapidly maturing newborns and premature babies the pharmacokinetics of each antibiotic must be known precisely. 4. Since in the individual case there can never be absolute certainty with respect to the three above-mentioned problems, combination therapy should be given at all times.
新生儿败血症的化疗与大龄儿童或成人有根本区别，因为尽管新生儿的免疫系统已完全发育，但该系统尚未“学会”完全发挥作用。最终，最佳化疗方案只能通过经验来确定。不过，在这方面可以给出一些基本指导原则：1. 初始治疗必须高度确定地控制病原体，因为在确定病原体后再调整治疗通常为时已晚。2. 由于抗生素在新生儿体内的药代动力学差异很大，观察到的最低血清峰浓度应超过病原体的最低抑菌浓度。3. 对于快速成熟的新生儿和早产儿，必须精确了解每种抗生素的药代动力学。4. 由于在个别情况下，对于上述三个问题永远无法有绝对把握，因此应始终采用联合治疗。
