Duration of empiric antibiotics for suspected early-onset sepsis in extremely low birth weight infants.
作者： Leandro Cordero , Leona W. Ayers
DOI: 10.1086/502270
关键词:
摘要: OBJECTIVES: To study multicenter antibiotic practices for suspected early-onset sepsis (EOS) with negative blood cultures (NegBCs) and to identify opportunities reduction of antimicrobial exposure. DESIGN: Retrospective study. SETTING: Thirty academic hospitals (University HealthSystem Consortium) located in 24 states. METHODS: Data were from a survey 790 extremely low birth weight (ELBW) infants. Total exposures (antibiotic-days per patient) calculated. RESULTS: On admission the NICU, 94% ELBW infants had BCs performed empiric antibiotics initiated. When PosBC NegBC compared, 47 patients PosBCs similar 695 NegBCs weight, gestational age (GA), mortality. Patients EOS but given ampicillin/aminoglycosides grouped by length administration GA. For GA 26 weeks or younger, 170 short (≤ 3 days) 157 long 7 course regarding mortality, antepartum history, CRIB scores, different (P <.01) number receiving third (3% 17%) antibiotic-days (23 38). 27 older, 113 77 differed (2% 23%) (19 30). CONCLUSIONS: Most are antibiotics, no historical risk factors neonatal clinical signs explained prolonged administration. Discontinuing when asymptomatic can reduce exposure without compromising outcome.
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