Abstract
Premature infants with risk factors for early onset sepsis who were less than seven days of age were blindly randomized to receive either piperacillin and placebo (200 infants) or ampicillin and amikacin (196 infants). One of 30 treated infants developed positive blood cultures. The overall mortality in the two groups was 8.5 % for piperacillin/placebo and 13.8 % for ampicillin/amikacin (p=0.11). Serum creatinine elevation above 100 µmol/l (1.131 mg/dl) during treatment was similar in the two groups. The effectiveness of piperacillin/placebo is similar to that of ampicillin/amikacin for empiric treatment of premature newborns with risk factors for early onset sepsis.
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La Gamma, E. F., Drusin, L. M., Mackles, A. W., Machalek, S., Auld, P. A. M. Neonatal infections. An important determinant of late NICU mortality in infants less than 1000 grams at birth. American Journal of Diseases of Children 1983, 137: 838–841.
Prober, C. Treatment of bacterial infections in the neonate. Clinical and Investigative Medicine 1985, 8: 368–370.
Soman, M., Green, B., Daling, J. Risk factors for early neonatal sepsis. American Journal of Epidemiology 1985, 121: 712–719.
Klein, J. O., Dashefsky, B., Norton, C. R., Mayer, J. Selection of antimicrobial agents for treatment of neonatal sepsis. Reviews of Infectious Diseases 1983, 5, Supplement: 55–62.
Fortner, C. L., Finley, R. S., Schimpff, S. C. Piperacillin sodium: antibacterial spectrum, pharmacokinetics, clinical efficacy, and adverse reactions. Pharmacotherapy 1982, 2: 287–299.
Hammerberg, O., Elder, D., Richardson, H., Landis, S. Staphylococcal resistance to aminoglycosides before and after the introduction of amikacin in two teaching hospitals. Journal of Clinical Microbiology 1986, 24: 629–632.
Hammerschlag, M. R., Klein, J. O., Herschel, M., Chen, F. C. J., Fermin, R. Patterns of use of antibiotics in two newborn nurseries. New England Journal of Medicine 1977, 296: 1268–1269.
Lietman, P. S., Smith, C. S. Aminoglycoside nephrotoxicity in humans. Reviews of Infectious Diseases 1983, 5, Supplement 2: S284-S293.
Stein, L., Ozdamar, O., Kraus, N., Paton, J. Follow-up of infants screened by auditory brainstem response in the newborn intensive care unit. Journal of Pediatrics 1983, 103: 447–453.
Gribble, M. J., Chow, A. W., Naiman, S. C., Smith, J. A., Bowie, W. R., Sacks, S. L., Grossman, L., Buskard, N., Growe, G. H., Plenderleith, L. H. Prospective randomized trial of piperacillin monotherapy versus carboxypenicillin-aminoglycoside combination regimens in the empiric treatment of serious bacterial infections. Antimicrobial Agents and Chemotherapy 1983, 24: 388–393.
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Hammerberg, O., Kurnitzki, C., Watts, J. et al. Randomized trial using piperacillin versus ampicillin and amikacin for treatment of premature neonates with risk factors for sepsis. Eur. J. Clin. Microbiol. Infect. Dis. 8, 241–244 (1989). https://doi.org/10.1007/BF01965268
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DOI: https://doi.org/10.1007/BF01965268