Seven versus 10 days antibiotic therapy for culture-proven neonatal sepsis: A randomised controlled trial.

Autor:	Rohatgi, Smriti, Dewan, Pooja, Faridi, Mohammad Moonis Akbar, Kumar, Ashwani, Malhotra, Rajeev Kumar, Batra, Prerna
Předmět:	ANTIBIOTICS NEONATAL sepsis DRUG efficacy PERINATAL care HEALTH outcome assessment THERAPEUTICS COMPARATIVE studies DRUG administration DOSE-effect relationship in pharmacology INTRAVENOUS therapy LONGITUDINAL method RESEARCH methodology MEDICAL cooperation MICROBIAL sensitivity tests RESEARCH RISK assessment STATISTICAL sampling EVALUATION research RANDOMIZED controlled trials TREATMENT effectiveness SEVERITY of illness index HOSPITAL mortality
Zdroj:	Journal of Paediatrics & Child Health; Jun2017, Vol. 53 Issue 6, p556-562, 7p, 1 Illustration
Abstrakt:	Aim: Optimal duration of parenteral antibiotics for treating neonatal sepsis ranges from 7-14 days. We compared the efficacy of 7 versus 10 days duration of intravenous antibiotics for neonatal septicaemia.Methods: We randomised blood culture-proven septic neonates (≥32 weeks and birth weight ≥1.5 kg) to receive either 7 or 10 days duration of intravenous antibiotics. We followed up neonates upto 28 days after stopping antibiotics for treatment failure defined by reappearance of clinical sepsis with a blood culture growing the same organism as cultured earlier, or in the absence of a positive culture, the presence of C-reactive protein and as adjudicated by an expert committee.Results: A total of 132 neonates were randomised to receive either 7 (n = 66) or 10 (n = 66) days duration of antibiotic therapy. Out of 128 neonates (64 per group) followed up, two (one per group) were regarded as 'treatment failure', and two were labelled as fresh episodes of sepsis (both in 10-day group). The risk (95% confidence interval) for treatment failure in the 7-day group was (1.0 (0.064-15.644) was not significantly higher. Neonates in both groups had comparable need for oxygen, inotropic support and blood products, duration of oxygen therapy and time to attainment of full feeds. The duration of hospitalisation was significantly longer in the 10-day group.Conclusion: A 7-day course of intravenous antibiotics may be sufficient to treat neonatal sepsis with the advantage of shorter hospital stay, but a larger meta-analysis would be required to state this with a degree of certainty. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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