Feasibility and efficacy of gentamicin for treating neonatal sepsis in community-based settings: a systematic review.

Autor: Jaiswal N; ICMR Advanced Centre for Evidence Based Child Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India., Singh M; ICMR Advanced Centre for Evidence Based Child Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India.; Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India., Kondel R; Department of Pharmacology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India., Kaur N; Department of Pharmacology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India., Thumburu KK; ICMR Advanced Centre for Evidence Based Child Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India., Kumar A; ICMR Advanced Centre for Evidence Based Child Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India., Kaur H; Department of Library, University Business School, Punjab University, Chandigarh, India., Chadha N; Dr. Tulsi Das Library, Postgraduate Institute of Medical Education and Research, Chandigarh, India., Gupta N; Department of Pediatrics, AIIMS, Jodhpur, Rajasthan, India., Agarwal A; ICMR Advanced Centre for Evidence Based Child Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India., Malhotra S; Department of Pharmacology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India., Shafiq N; Department of Pharmacology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India. nusrat_shafiq@hotmail.com.
Jazyk: angličtina
Zdroj: World journal of pediatrics : WJP [World J Pediatr] 2016 Nov; Vol. 12 (4), pp. 408-414. Date of Electronic Publication: 2016 Feb 01.
DOI: 10.1007/s12519-016-0005-2
Abstrakt: Background: Neonatal sepsis is a leading cause of neonatal deaths in developing countries. The current recommended in-hospital treatment is parenteral ampicillin (or penicillin) and gentamicin in young infants for 10- 14 days; however, very few could access and afford. The current review is to evaluate the feasibility of gentamicin in community based settings.
Methods: Both observational and randomized controlled trials were included. Medline, Embase, Cochrane Central Register of Controlled Trials and Central Trial Register of India were searched until September 2013. We assessed the risk of bias by Cochrane Collaboration's "risk of bias" tool.
Results: Two observational studies indicated feasibility ensuring coverage of population, decrease in case fatality rate in the group treated by community health workers. In an RCT, no significant difference was observed in the treatment failure rates [odds ratio (OR)=0.88], and the mortality in the first and second week (OR=1.53; OR=2.24) between gentamicin and ceftriaxone groups. Within the gentamicin group, the combination of penicillin and gentamicin showed a lower rate of treatment failure (OR=0.44) and mortality at second week of life (OR=0.17) as compared to the combination of gentamicin and oral cotrimoxazole.
Conclusion: Gentamicin for the treatment of neonatal sepsis is both feasible and effective in community-based settings and can be used as an alternative to the hospitalbased care in resource compromised settings. But there was less evidence in the management of neonatal sepsis in hospitals as was seen in this review in which we included only one RCT and three observational studies.
Databáze: MEDLINE
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