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Appropriate use of antibiotics in the NICU

Year 2010, Volume: 15 Issue: 4, 133 - 138, 17.01.2013

Abstract

Abstract. Antibiotics are a very important group of drugs for the sick neonate and have undoubtedly played a role in their improved survival. But they come with a set of risks which must be carefully considered and weighed against the benefits in any decision to commence antibiotics. For the neonatologist this is not an easy task. This article intends to discuss the potential risks of antibiotics to the sick newborn in the hope that it will aid clinicians to better balance the benefits and harms and use antibiotics in a rational way.

Key words: Neonates, antibiotics, policy, infection, sepsis

References

  • Inglis GD, Davies MW. Prophylactic antibiotics to reduce morbidity and mortality in ventilated newborn infants. Cochrane Database Syst Rev 2004(1):CD004338.
  • Austin N, Darlow BA, McGuire W. Prophylactic oral/topical non-absorbed antifungal agents to prevent invasive fungal infection in very low birth weight infants. Cochrane Database Syst Rev 2009(4):CD003478.
  • Sostarich AM, Zolldann D, Haefner H, et al. Impact of multiresistance of gram-negative bacteria in bloodstream infection on mortality rates and length of stay. Infection 2008; 36:31-35.
  • 1Blakey JL, Lubitz L, Campbell NT, et al. Enteric colonization in sporadic neonatal necrotizing enterocolitis. J Pediatr Gastroenterol Nutr 1985; 4: 591-595.
  • Stark PL, Lee A. The microbial ecology of the large bowel of breast-fed and formula-fed infants during the first year of life. J Med Microbiol 1982; 15: 189-203.
  • Stark PL, Lee A. The bacterial colonization of the large bowel of pre-term low birth weight neonates. J Hyg (Lond) 1982; 89: 59-67.
  • Rotimi VO, Duerden BI. The bacterial flora of neonates with congenital abnormalities of the gastro-intestinal tract. J Hyg (Lond) 1982; 88: 69- 81.
  • Sakata H, Yoshioka H, Fujita K. Development of the intestinal flora in very low birth weight infants compared to normal full-term newborns. Eur J Pediatr 1985; 144: 186-190.
  • Hall MA, Cole CB, Smith SL, Fuller R, Rolles CJ. Factors influencing the presence of faecal lactobacilli in early infancy. Arch Dis Child 1990; 65: 185-188.
  • Gewolb IH, Schwalbe RS, Taciak VL, Harrison TS, Panigrahi P. Stool microflora in extremely low birthweight infants. Arch Dis Child Fetal Neonatal Ed 1999; 80: F167-F173.
  • Mazmanian SK, Liu CH, Tzianabos AO, Kasper DL. An immunomodulatory molecule of symbiotic bacteria directs maturation of the host immune system. Cell 2005; 122: 107-118.
  • Rakoff-Nahoum S, Paglino J, Eslami-Varzaneh F, Edberg S, Medzhitov R. Recognition of commensal microflora by toll-like receptors is required for intestinal homeostasis. Cell 2004; 118: 229-241.
  • Isolauri E, Sutas Y, Kankaanpaa P, Arvilommi H, Salminen S. Probiotics: effects on immunity. Am J Clin Nutr 2001; 73: 444S-450S.
  • de Man P, Verhoeven BA, Verbrugh HA, Vos MC, van den Anker JN. An antibiotic policy to prevent emergence of resistant bacilli. Lancet 2000; 355: 973-978.
  • Clark R, Powers R, White R, et al. Prevention and treatment of nosocomial sepsis in the NICU. J Perinatol 2004; 24: 446-453.
  • National Centre for Infectious Diseases CfDC. Prevention of Perinatal Group B Streptococcal Disease: Revised Guidelines from CDC. MMWR 2002; 51((RR11)):1-22.
  • Jardine L, Davies MW, Faoagali J. Incubation time required for neonatal blood cultures to become positive. J Paediatr Child Health 2006; 42: 797-802.
  • Jardine LA, Sturgess BR, Inglis GD, Davies MW. Neonatal blood cultures: effect of delayed entry into the blood culture machine and bacterial concentration on the time to positive growth in a simulated model. J Paediatr Child Health 2009; 45: 210-214.
  • Manroe BL, Weinberg AG, Rosenfeld CR, Browne R. The neonatal blood count in health and disease. I. Reference values for neutrophilic cells. J Pediatr 1979; 95: 89-98.
  • Dollner H, Vatten L, Austgulen R. Early diagnostic markers for neonatal sepsis: comparing C-reactive protein, interleukin-6, soluble tumour necrosis factor receptors and soluble adhesion molecules. J Clin Epidemiol 2001; 54: 1251-1257.
  • Kordek A, Halasa M, Podraza W. Early detection of an early onset infection in the neonate based on measurements of procalcitonin and C-reactive protein concentrations in cord blood. Clin Chem Lab Med 2008; 46: 1143-1148.
  • Gordon A, Isaacs D. Late onset neonatal Gram- negative bacillary infection in Australia and New Zealand: 1992-2002. Pediatr Infect Dis J 2006; 25: 25-29.
  • Hoshuyama T, Moriguchi H, Muratani T, Matsumoto T. Vancomycin-resistant enterococci (VRE) outbreak at a university hospital in Kitakyushu, Japan: case-control studies. J Infect Chemother 2008; 14: 354-360.
  • Duchon J, Graham Iii P, Della-Latta P, et al. Epidemiology of enterococci in a neonatal intensive care unit. Infect Control Hosp Epidemiol 2008; 29: 374-376.
  • Karlowicz MG, Buescher ES, Surka AE. Fulminant late-onset sepsis in a neonatal intensive care unit, 1988-1997, and the impact of avoiding empiric vancomycin therapy. Pediatrics 2000; 106: 1387-1390.
  • Verpooten GA, Giuliano RA, Verbist L, Eestermans G, De Broe ME. Once-daily dosing decreases renal accumulation of gentamicin and netilmicin. Clin Pharmacol Ther 1989; 45: 22-27.
  • Beaubien AR, Desjardins S, Ormsby E, et al. Incidence of amikacin ototoxicity: a sigmoid function of total drug exposure independent of plasma levels. Am J Otolaryngol 1989; 10: 234- 243.
  • Aust G. Vestibulotoxicity and ototoxicity of gentamicin in newborns at risk. Int Tinnitus J 2001; 7: 27-29.
Year 2010, Volume: 15 Issue: 4, 133 - 138, 17.01.2013

Abstract

References

  • Inglis GD, Davies MW. Prophylactic antibiotics to reduce morbidity and mortality in ventilated newborn infants. Cochrane Database Syst Rev 2004(1):CD004338.
  • Austin N, Darlow BA, McGuire W. Prophylactic oral/topical non-absorbed antifungal agents to prevent invasive fungal infection in very low birth weight infants. Cochrane Database Syst Rev 2009(4):CD003478.
  • Sostarich AM, Zolldann D, Haefner H, et al. Impact of multiresistance of gram-negative bacteria in bloodstream infection on mortality rates and length of stay. Infection 2008; 36:31-35.
  • 1Blakey JL, Lubitz L, Campbell NT, et al. Enteric colonization in sporadic neonatal necrotizing enterocolitis. J Pediatr Gastroenterol Nutr 1985; 4: 591-595.
  • Stark PL, Lee A. The microbial ecology of the large bowel of breast-fed and formula-fed infants during the first year of life. J Med Microbiol 1982; 15: 189-203.
  • Stark PL, Lee A. The bacterial colonization of the large bowel of pre-term low birth weight neonates. J Hyg (Lond) 1982; 89: 59-67.
  • Rotimi VO, Duerden BI. The bacterial flora of neonates with congenital abnormalities of the gastro-intestinal tract. J Hyg (Lond) 1982; 88: 69- 81.
  • Sakata H, Yoshioka H, Fujita K. Development of the intestinal flora in very low birth weight infants compared to normal full-term newborns. Eur J Pediatr 1985; 144: 186-190.
  • Hall MA, Cole CB, Smith SL, Fuller R, Rolles CJ. Factors influencing the presence of faecal lactobacilli in early infancy. Arch Dis Child 1990; 65: 185-188.
  • Gewolb IH, Schwalbe RS, Taciak VL, Harrison TS, Panigrahi P. Stool microflora in extremely low birthweight infants. Arch Dis Child Fetal Neonatal Ed 1999; 80: F167-F173.
  • Mazmanian SK, Liu CH, Tzianabos AO, Kasper DL. An immunomodulatory molecule of symbiotic bacteria directs maturation of the host immune system. Cell 2005; 122: 107-118.
  • Rakoff-Nahoum S, Paglino J, Eslami-Varzaneh F, Edberg S, Medzhitov R. Recognition of commensal microflora by toll-like receptors is required for intestinal homeostasis. Cell 2004; 118: 229-241.
  • Isolauri E, Sutas Y, Kankaanpaa P, Arvilommi H, Salminen S. Probiotics: effects on immunity. Am J Clin Nutr 2001; 73: 444S-450S.
  • de Man P, Verhoeven BA, Verbrugh HA, Vos MC, van den Anker JN. An antibiotic policy to prevent emergence of resistant bacilli. Lancet 2000; 355: 973-978.
  • Clark R, Powers R, White R, et al. Prevention and treatment of nosocomial sepsis in the NICU. J Perinatol 2004; 24: 446-453.
  • National Centre for Infectious Diseases CfDC. Prevention of Perinatal Group B Streptococcal Disease: Revised Guidelines from CDC. MMWR 2002; 51((RR11)):1-22.
  • Jardine L, Davies MW, Faoagali J. Incubation time required for neonatal blood cultures to become positive. J Paediatr Child Health 2006; 42: 797-802.
  • Jardine LA, Sturgess BR, Inglis GD, Davies MW. Neonatal blood cultures: effect of delayed entry into the blood culture machine and bacterial concentration on the time to positive growth in a simulated model. J Paediatr Child Health 2009; 45: 210-214.
  • Manroe BL, Weinberg AG, Rosenfeld CR, Browne R. The neonatal blood count in health and disease. I. Reference values for neutrophilic cells. J Pediatr 1979; 95: 89-98.
  • Dollner H, Vatten L, Austgulen R. Early diagnostic markers for neonatal sepsis: comparing C-reactive protein, interleukin-6, soluble tumour necrosis factor receptors and soluble adhesion molecules. J Clin Epidemiol 2001; 54: 1251-1257.
  • Kordek A, Halasa M, Podraza W. Early detection of an early onset infection in the neonate based on measurements of procalcitonin and C-reactive protein concentrations in cord blood. Clin Chem Lab Med 2008; 46: 1143-1148.
  • Gordon A, Isaacs D. Late onset neonatal Gram- negative bacillary infection in Australia and New Zealand: 1992-2002. Pediatr Infect Dis J 2006; 25: 25-29.
  • Hoshuyama T, Moriguchi H, Muratani T, Matsumoto T. Vancomycin-resistant enterococci (VRE) outbreak at a university hospital in Kitakyushu, Japan: case-control studies. J Infect Chemother 2008; 14: 354-360.
  • Duchon J, Graham Iii P, Della-Latta P, et al. Epidemiology of enterococci in a neonatal intensive care unit. Infect Control Hosp Epidemiol 2008; 29: 374-376.
  • Karlowicz MG, Buescher ES, Surka AE. Fulminant late-onset sepsis in a neonatal intensive care unit, 1988-1997, and the impact of avoiding empiric vancomycin therapy. Pediatrics 2000; 106: 1387-1390.
  • Verpooten GA, Giuliano RA, Verbist L, Eestermans G, De Broe ME. Once-daily dosing decreases renal accumulation of gentamicin and netilmicin. Clin Pharmacol Ther 1989; 45: 22-27.
  • Beaubien AR, Desjardins S, Ormsby E, et al. Incidence of amikacin ototoxicity: a sigmoid function of total drug exposure independent of plasma levels. Am J Otolaryngol 1989; 10: 234- 243.
  • Aust G. Vestibulotoxicity and ototoxicity of gentamicin in newborns at risk. Int Tinnitus J 2001; 7: 27-29.
There are 28 citations in total.

Details

Primary Language English
Journal Section Letter to the Editor
Authors

Jacqueline J Ho This is me

Publication Date January 17, 2013
Published in Issue Year 2010 Volume: 15 Issue: 4

Cite

APA J Ho, J. (2013). Appropriate use of antibiotics in the NICU. EASTERN JOURNAL OF MEDICINE, 15(4), 133-138.
AMA J Ho J. Appropriate use of antibiotics in the NICU. EASTERN JOURNAL OF MEDICINE. March 2013;15(4):133-138.
Chicago J Ho, Jacqueline. “Appropriate Use of Antibiotics in the NICU”. EASTERN JOURNAL OF MEDICINE 15, no. 4 (March 2013): 133-38.
EndNote J Ho J (March 1, 2013) Appropriate use of antibiotics in the NICU. EASTERN JOURNAL OF MEDICINE 15 4 133–138.
IEEE J. J Ho, “Appropriate use of antibiotics in the NICU”, EASTERN JOURNAL OF MEDICINE, vol. 15, no. 4, pp. 133–138, 2013.
ISNAD J Ho, Jacqueline. “Appropriate Use of Antibiotics in the NICU”. EASTERN JOURNAL OF MEDICINE 15/4 (March 2013), 133-138.
JAMA J Ho J. Appropriate use of antibiotics in the NICU. EASTERN JOURNAL OF MEDICINE. 2013;15:133–138.
MLA J Ho, Jacqueline. “Appropriate Use of Antibiotics in the NICU”. EASTERN JOURNAL OF MEDICINE, vol. 15, no. 4, 2013, pp. 133-8.
Vancouver J Ho J. Appropriate use of antibiotics in the NICU. EASTERN JOURNAL OF MEDICINE. 2013;15(4):133-8.