Araştırma Makalesi
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Yenidoğanın geçici takipnesinde antibiyotikler; Komorbiditeler sebep mi sonuç mu?

Yıl 2020, Cilt: 17 Sayı: 1, 254 - 257, 31.03.2020

Öz

Amaç: Yenidoğanın geçici takipnesi(YDGT) tanısı alan, antibiyotik tedavisi verilen ve konservatif tedavi uygulanan geç pematüre ve term yenidoğanların, enfeksiyöz komplikasyonlar, pulmoner hava kaçağı ve hastanede kalış süresi açısından karşılaştırılması amaçlanmıştır.
Gereçler ve Yöntem: Bu prospektif çalışma, Zekai Tahir Burak Kadın Sağlığı Eğitim ve Araştırma Hastanesi, Sağlık Bilimleri Üniversitesi, Tıp Fakültesi'nde yürütüldü. İki yüz doksan bir bebek çalışmaya dahil edildi ve 101'ine (% 34.7) antibiyotik tedavisi verildi ve 190' ına (% 65.3) konservatif tedavi uygulandı.
Bulgular: Antibiyotik ile tedavi edilen bebeklerde, konvansiyonel tedavi ile izlenen bebeklerle karşılaştırıldığında daha fazla non-invaziv solunum desteği gereksinimi (% 57 -% 21, p <0.0001), daha uzun hastanede kalış süresi (7.8 ± 3.6 ve 5.5 ± 3.1 gün, P <0.0001), daha fazla enfeksiyöz komplikasyon (%16.8 ve -% 0.5, p <0.0001) ve pulmoner hava kaçağı komplikasyonları (% 8.9 -% 0.5, p <0.01) olduğu görüldü.
Sonuçlar: Antibiyotik ile tedavi edilen YDGT’li bebeklerde enfeksiyöz komplikasyonlar ile birlikte pulmoner hava kaçağı komplikasyonu da daha fazla olduğu görülmüştür. Antibiyotik tedavisi görmeyen YDGT'li bebeklerin hastanede yatış sürelerinin daha kısa olması nedeni ile hastanede uzun süre yatış nedeni ile ortaya çıkabilecek komplikasyonların da önüne geçmesini sağlamıştır. Elde ettiğimiz sonuçlar ışığında, YDGT'li bebeklerin çoğunun gereksiz antibiyotik aldığını düşünmekteyiz.

Destekleyen Kurum

yok

Kaynakça

  • Referans 1. Avery ME, Gatewood OB, Brumley G: Transient tachypnea of newborn. Possible delayed resorption of fluid at birth. Am J Dis Child 1966;111:380–385.
  • Referans 2. Helve O, Janer C, Pitkanen O, Andersson S: Expression of the epithelial sodium channel in airway epithelium of newborn infants depends on gestational age. Pediatrics 2007;120:1311–1316.
  • Referans 3. te Pas AB, Davis PG, Hooper SB, Morley CJ: From liquid to air: breathing after birth. J Pediatr 2008;152: 607–611.
  • Referans 4. Kasap B, Duman N, Özer E, Tatli M, Kumral A, Özkan H: Transient tachypnea of the newborn: predictive factor for prolonged tachypnea. Pediatr Int 2008;50:81–4.
  • Referans 5. Jain L, Eaton DC: Physiology of fetal lung fluid clearance and the effect of labor. Semin Perinatol 2006;30:34–43.
  • Referans 6. Miller MJ, Fanaroff AA, Martin RJ: Respiratory disorders in preterm and term infants. in: Fanaroff AA, Martin RJ, (eds) Neonatal-Perinatal Medicine. Diseases of the fetus and infant, 7th edition. Mosby, St Louis, 2002, pp 1025–1049.
  • Referans 7. Birnkrant DJ, Picone C, Markowitz W, El Khwad M, Shen WH, Tafari N: Association of transient tachypnea of the newborn and childhood asthma. Pediatr Pulmonol 2006;41:978.
  • Referans 8. Demissie K, Marcella SW, Breckenridge MB, Rhoads GG: Maternal asthma and transient tachypnea of the newborn. Pediatrics 1998;102:84.
  • Referans 9. Kolås T, Saugstad OD, Daltveit AK, Nilsen ST, Oian P: Planned cesarean versus planned vaginal delivery at term: comparison of newborn infant outcomes. Am J Obstet Gynecol 2006;195:1538-43.
  • Referans 10. Levine EM, Ghai V, Barton JJ, Strom CM: Mode of delivery and risk of respiratory diseases in newborns. Obstet Gynecol 2001;97:439.
  • Referans 11. Persson B, Hanson U: Neonatal morbidities in gestational diabetes mellitus. Diabetes Care 1998;21 Suppl 2:B79.
  • Referans 12. Weintraub AS, Cadet CT, Perez R, DeLorenzo E, Holzman IR, Stroustrup A: Antibiotic Use in Newborns with Transient Tachypnea of the Newborn. Neonatology 2013;103:235–240.
  • Referans 13. Costa S, Rocha G, Leitao A, Guimaraes H: Transient tachypnea of the newborn and congenital pneumonia: a comparative study. J Matern Fetal Neonatal Med 2012;25: 992–994.
  • Referans 14. Hermansen CL, Lorah KN: Respiratory distress in the newborn. Am Fam Physician 2007;76: 987–994.
  • Referans 15. Martin RJ, Fanaroff AA, Walsh MC: Fanaroff and Martin’s Neonatal-Perinatal Medicine:Diseases of the Fetus and Infant, ed 9. Philadelphia,Saunders/Elsevier, 2011.
  • Referans 16. Li J, Wu J, Du L, Hu Y, Yang X, Mu D, Xia B: Different antibiotic strategies in transient tachypnea of the newborn: an ambispective cohort study. Eur J Pediatr. 2015;174(9):1217-23.
  • Referans 17. Madansky DL, Lawson EE, Chernick V, Taeusch HW Jr: Pneumothorax and Other Forms of Pulmonary Air Leak in Newborns Am Rev Respir Dis. 1979;120(4):729-37.

Antibiotics for transient tachypnea of newborn; are comorbidities reasons or results?

Yıl 2020, Cilt: 17 Sayı: 1, 254 - 257, 31.03.2020

Öz

Aim: To compare late preterm and term newborns administered antibiotic treatment and conservative management with the diagnosis of TTN including infectious complications, pulmonary air leak and length of hospital stay.
Materials and methods: This prospective study was carried out at Zekai Tahir Burak Women’s Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences. Two hundred and ninety one infants were included in the study and 101 (34.7%) were given antibiotic treatment and 190 (65.3%) were followed with conservative treatment.
Results: Infants treated with antibiotics required more noninvasive respiratory support (57% vs 21%, p<0.0001), had a longer duration of hospital stay (7.8±3.6 vs 5.5±3.1 days, P<0.0001), more infectious complications (16.8% vs 0.5%, p<0.0001) and pulmonary air leak complications (8.9% vs 0.5%, p<0.01) than untreated infants.
Conclusions: Infants with TTN treated with antibiotics have not only more infectious complications but also more pulmonary air leak than untreated infants. Infants with TTN not treated with antibiotics have a shorter length of hospital stay possibly preventing complications related to longer hospital stay. In the light of our results we emphasize that most infants with TTN receive unnecessary antibiotics.

Kaynakça

  • Referans 1. Avery ME, Gatewood OB, Brumley G: Transient tachypnea of newborn. Possible delayed resorption of fluid at birth. Am J Dis Child 1966;111:380–385.
  • Referans 2. Helve O, Janer C, Pitkanen O, Andersson S: Expression of the epithelial sodium channel in airway epithelium of newborn infants depends on gestational age. Pediatrics 2007;120:1311–1316.
  • Referans 3. te Pas AB, Davis PG, Hooper SB, Morley CJ: From liquid to air: breathing after birth. J Pediatr 2008;152: 607–611.
  • Referans 4. Kasap B, Duman N, Özer E, Tatli M, Kumral A, Özkan H: Transient tachypnea of the newborn: predictive factor for prolonged tachypnea. Pediatr Int 2008;50:81–4.
  • Referans 5. Jain L, Eaton DC: Physiology of fetal lung fluid clearance and the effect of labor. Semin Perinatol 2006;30:34–43.
  • Referans 6. Miller MJ, Fanaroff AA, Martin RJ: Respiratory disorders in preterm and term infants. in: Fanaroff AA, Martin RJ, (eds) Neonatal-Perinatal Medicine. Diseases of the fetus and infant, 7th edition. Mosby, St Louis, 2002, pp 1025–1049.
  • Referans 7. Birnkrant DJ, Picone C, Markowitz W, El Khwad M, Shen WH, Tafari N: Association of transient tachypnea of the newborn and childhood asthma. Pediatr Pulmonol 2006;41:978.
  • Referans 8. Demissie K, Marcella SW, Breckenridge MB, Rhoads GG: Maternal asthma and transient tachypnea of the newborn. Pediatrics 1998;102:84.
  • Referans 9. Kolås T, Saugstad OD, Daltveit AK, Nilsen ST, Oian P: Planned cesarean versus planned vaginal delivery at term: comparison of newborn infant outcomes. Am J Obstet Gynecol 2006;195:1538-43.
  • Referans 10. Levine EM, Ghai V, Barton JJ, Strom CM: Mode of delivery and risk of respiratory diseases in newborns. Obstet Gynecol 2001;97:439.
  • Referans 11. Persson B, Hanson U: Neonatal morbidities in gestational diabetes mellitus. Diabetes Care 1998;21 Suppl 2:B79.
  • Referans 12. Weintraub AS, Cadet CT, Perez R, DeLorenzo E, Holzman IR, Stroustrup A: Antibiotic Use in Newborns with Transient Tachypnea of the Newborn. Neonatology 2013;103:235–240.
  • Referans 13. Costa S, Rocha G, Leitao A, Guimaraes H: Transient tachypnea of the newborn and congenital pneumonia: a comparative study. J Matern Fetal Neonatal Med 2012;25: 992–994.
  • Referans 14. Hermansen CL, Lorah KN: Respiratory distress in the newborn. Am Fam Physician 2007;76: 987–994.
  • Referans 15. Martin RJ, Fanaroff AA, Walsh MC: Fanaroff and Martin’s Neonatal-Perinatal Medicine:Diseases of the Fetus and Infant, ed 9. Philadelphia,Saunders/Elsevier, 2011.
  • Referans 16. Li J, Wu J, Du L, Hu Y, Yang X, Mu D, Xia B: Different antibiotic strategies in transient tachypnea of the newborn: an ambispective cohort study. Eur J Pediatr. 2015;174(9):1217-23.
  • Referans 17. Madansky DL, Lawson EE, Chernick V, Taeusch HW Jr: Pneumothorax and Other Forms of Pulmonary Air Leak in Newborns Am Rev Respir Dis. 1979;120(4):729-37.
Toplam 17 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Çocuk Sağlığı ve Hastalıkları
Bölüm Research Article
Yazarlar

Erbu Yarcı 0000-0003-4434-0958

Asihan Kose Cetinkaya Bu kişi benim 0000-0003-0265-0229

Fuat Emre Canpolat 0000-0001-9307-3003

Yayımlanma Tarihi 31 Mart 2020
Gönderilme Tarihi 31 Aralık 2019
Kabul Tarihi 24 Şubat 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 17 Sayı: 1

Kaynak Göster

Vancouver Yarcı E, Kose Cetinkaya A, Canpolat FE. Antibiotics for transient tachypnea of newborn; are comorbidities reasons or results?. JGON. 2020;17(1):254-7.