Pneumonia in Term Neonates: Laboratory Studies and Duration of Antibiotic Therapy
| Autor: | Sithembiso Velaphi, Ian C. Michelow, Kathleen M McHugh, Debra A. Vedro, William D. Engle, Kurt Olsen, Margienetta R Norris, Gregory L. Jackson, Dorothy M. Sendelbach, Diane M Ford, Elizabeth K. Stehel |
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| Rok vydání: | 2003 |
| Předmět: |
Male
medicine.medical_specialty Randomization Population Gestational Age Penicillins Injections Intramuscular Drug Administration Schedule Procalcitonin Reference Values Intensive Care Units Neonatal Internal medicine Antibiotic therapy Pneumonia Bacterial Birth Weight Humans Medicine Prospective Studies Respiratory system education Probability education.field_of_study Dose-Response Relationship Drug Clinical Laboratory Techniques business.industry Infant Newborn Obstetrics and Gynecology Term neonates medicine.disease Anti-Bacterial Agents Surgery Pneumonia Treatment Outcome Pediatrics Perinatology and Child Health Population study Ampicillin Female Gentamicins business Follow-Up Studies |
| Zdroj: | Journal of Perinatology. 23:372-377 |
| ISSN: | 1476-5543 0743-8346 |
| DOI: | 10.1038/sj.jp.7210949 |
| Popis: | OBJECTIVES: To compare 2 days of antibiotic therapy (AT) to 4 days of AT in neonates with pneumonia and to assess the usefulness of neutrophil values (NV), C-reactive protein (CRP), and procalcitonin (PCT) in this population. DESIGN:The study population consisted of consecutive, eligible term neonates begun on AT for suspected pneumonia. Of 51 neonates, 26 qualified for randomization (14, 2-day group; 12, 4-day group). NV were obtained with the initial evaluation and 12 and 24 hours later. CRP and PCT were obtained 12 and 48 hours after the initial evaluation. RESULTS: None of the 12 neonates in the 4-day group developed recurrent respiratory symptoms. Three of the 14 neonates randomized to the 2-day group had recurrence of symptoms, resulting in study termination. NV, CRP, and PCT were similar in the 2- and 4-day groups. In the three neonates who developed respiratory symptoms, all absolute total neutrophil values and five out of nine absolute total immature neutrophil values were abnormal. However, all immature:total neutrophil values were normal, and CRP was strikingly elevated in only one neonate; only one of six PCT values was abnormal. In a secondary analysis of all 51 study neonates, CRP and PCT did not provide additional benefit over NV in differentiating neonates with pneumonia. CONCLUSIONS:Four days of AT appears to be adequate for selected term neonates with pneumonia; however, 2 days of AT appears to be inadequate for this population. Relative to NV, CRP and PCT appear to have a limited role. |
| Databáze: | OpenAIRE |
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