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

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

The Influence of Heated Soil in Crop of “Tamaris” Tomato Plants on the Biological Activity of the Rhizosphere Soil

Tomato is a plant with high heat requirements and sensitive to cold weather and frost. The optimum temperature for the growth of tomato plants is between 21˚C and 27˚C during the day and between 17˚C and 21˚C at night. The soil temperature is also very important for plant growth. The optimum soil temperature for tomato cultivation should be within the range 15˚C - 18˚C. Besides, the proper development of the root system depends on the optimal temperature of the soil. A temperature below 14˚C reduces and inhibits the growth of the root system and encourages the development of fungal and bacterial diseases. In this study, the authors aimed to evaluate the effect of heated soil on the population of bacteria, fungi and nematodes inhabiting the soil of tomato cultivar “Tamaris” growing in peat and coconut substrates. The experiment was carried out in 12 treatments and in 3 replications (one slab was one replication). The soils were tested in two different types of containers: cylinders...
发表评论
阅读全文

Effect of Proline Pretreatment on Grapevine Shoot-Tip Response to a Droplet-Vitrification Protocol

Proline is an α-amino acid that is used in the biosynthesis of proteins. Some studies have shown that proline has been accumulated in plants in response to biotic and abiotic stresses. Exogenous proline has thus been used for improving some plant cryopreservation protocols. Further enhancement of cryopreservation efficiency for  in vitro  grapevines could be expected if stresses linked to cryopreservation procedures could be reduced. In this study, the authors studied the possible beneficial effect of proline in grapevine cryopreservation. Single-node explants from  in vitro  grown grapevine plantlets ( Vitis vinifera  L. cv Portan) were cultured on shooting media (half-strength MS + 1 μM BAP) containing no proline (control) or 50, 500, or 2000 μM filter-sterilized L-proline. Shoot tips excised from these microshoots were subjected to a PVS2-based droplet-vitrification procedure. Control and rewarmed explants were grown on a recovery medium containing ...
发表评论
阅读全文