跳至主要内容

Antibiotic Use in a Cohort of Extremely Low Birth Weight Neonates: Focus on Off-Label Uses and Prescription Behaviour

In the last decades, the survival of extremely low birth weight (ELBW) neonates (BW ≤ 1000 g) has improved dramatically due to advances in perinatal and neonatal care and better understanding of their physiopathology. These neonates, characterized by a great immaturity, are more exposed to risks to develop different morbidities and in particular are vulnerable to bacterial and fungal infections.

Antibiotics are medications used to fight infections caused by bacteria. Nowadays, a large variability in the use of antibiotics for the treatment of suspected/confirmed neonatal sepsis persists between different European Neonatal Intensive Care Units (NICUs) and most agents are still used in an off-label (OL) manner. In this paper, the authors aimed to analyze antibiotic prescriptions in a cohort of extremely low birth weight neonates admitted to Italian level III Neonatal intensive Care Units. 

An online questionnaire was used to collect detailed information for each newborn. Antibiotic prescriptions were classified about their license status and compared with British National Formulary for Children (BNFC) and with a practical guide prepared by the Italian Society of Neonatology (ISN). Data were collected in a database and summarized using standard descriptive methods.

During the study period (May - July 2014) among 93 neonates admitted to 30 Italian Neonatal intensive Care Units, 56 (60%) received at least an antibiotic (92 prescriptions in total). Ampicillin, gentamicin and vancomycin were the antibiotics most commonly used for the prevention/treatment of bacterial infections. 56/92 antibiotic prescriptions (61%) resulted off-label mainly as regards dosing frequency, while 13 prescriptions (14%) regarded antibiotics used in absence of specific indication for newborns (meropenem, imipenem, piperacillin/tazobactam, clindamycin, clarithromycin). 50/56 neonates (89.3%) received at least one off-label antibiotic prescription. Differences have been observed in dosing regimens between current study and recommendations contained in BNFC, while prescriptions adhered more frequently to ISN indications. 

In summary, our results confirm the high prevalence of off-label antibiotic use in ELBW neonates and underline a better adherence to indications based on clinical practice.


Article by Laura Cuzzolin and Rocco Agostino, from Italy.

Full access: http://suo.im/4xw8iK

评论

发表评论

此博客中的热门博文

Identifying Sustainable Practices for Tapping and Sap Collection from Birch Trees

Tapping and collecting sap from birch trees ( Betula , sp.) for the production of beverages and syrup is gaining increased levels of interest. Although the practice of tapping birch trees and collecting sap has been ongoing for millennia across the world, there remain some critical data needed in order to make science-based decisions about the production practices required to optimize yields and ensure sustainable outcomes are achieved in the long-term. In this study, experiments were conducted to determine two pieces of information essential to identify practices necessary to ensure tapping trees for birch sap collection were both sustainable and profitable—the selection of the time to initiate tapping birch trees to obtain maximum yields, and the volume of nonconductive wood (NCW) associated with taphole wounds in birch trees. The yields obtained from various timing treatments varied between sapflow seasons, but indicated that using test tapholes to choose the appropriate ti
发表评论
阅读全文

Incorporation of High-Altitude Balloon Experiment in High School Science Classrooms

High-altitude balloon is a balloon, filled usually with helium or hydrogen that ascends into an area called “near space” or stratosphere. The most common type of high-altitude balloons are weather balloons. Other purposes include use as a platform for experiments in the upper atmosphere. Modern balloons generally contain electronic equipment such as radio transmitters, cameras, or satellite navigation systems, such as GPS receivers. The mission of the High-Altitude Balloon Experiment (HABE) is to acquire supporting data, validate enabling technologies, and resolve critical acquisition, tracking, and pointing (ATP) and fire control issues in support of future space-based precision pointing experiments. The use of high-altitude balloons offers a relatively low-cost, low-vibration test platform, a recoverable and reusable payload, worldwide launch capability, and a 'near- space' emulation of the future space systems operational scenarios. More recently, several university
1 条评论
阅读全文

Esophageal Carcinogenesis

Read full paper at: http://www.scirp.org/journal/PaperInformation.aspx?PaperID=50380#.VDy9v1fHRK0 Author(s)   Naoki Watanabe 1 , Masahito Shimizu 2 , Takahiro Kochi 2 , Yohei Shirakami 2 , Takuji Tanaka 1,3* Affiliation(s) 1 Department of Diagnostic Pathology (DDP) & Research Center of Diagnostic Pathology (RC-DiP), Gifu Municipal Hospital, Gifu, Japan . 2 Department of Internal Medicine/Gastroenterology, Gifu University Graduate School of Medicine, Gifu, Japan . 3 Department of Tumor Pathology, Gifu University Graduate School of Medicine, Gifu, Japan . ABSTRACT Esophageal cancer is the sixth leading cause of cancer death and remains one of the least survivable cancers. Esophageal cancers show wide variations in incidence in different pop
发表评论
阅读全文