Abstract：Objective To observe the outcomes of hospitalized neonates who were managed with two different antibiotics strategies, namely, the risk factor based antibiotic strategy and the combination antibiotic strategy that is based on risk factors, infection screening and monitoring. Methods A cohort study was performed on a control group of 4 406 cases of neonates hospitalized between January 2010 and May 2011 and an observed group of 4 476 neonates hospitalized between July 2011 and October 2012. The control group adopted the risk factor based antibiotic strategy and the observed group received a combination antibiotic strategy based on risk factors, infection screening and monitoring. The rate of antibiotic use, average length of stay, readmission rate and mortality rate were compared between the two groups. Results With the change from the risk factor based antibiotic strategy to the combination antibiotic strategy, the total rate of antibiotic use decreased from 79.6% to 50.5% (P<0.01). There were no differences in the average length of stay, readmission rate, and mortality rate between the two groups. Conclusions The combination antibiotic strategy based on risk factors, infection screening and monitoring can reduce antibiotic use substantially and has no adverse effects on treatment outcomes in hospitalized neonates.
XIA Bin,WU Jin-Lin,ZHANG Li et al. Influence of different antibiotic strategies on outcomes of hospitalized neonates[J]. CJCP, 2013, 15(12): 1089-1092.
Gray JW. Surveillance of infection in neonatal intensive care units[J]. Early Hum Dev, 2007, 83(3): 157-163.
[3]
Philip AG. Response of C-reactive protein in neonatal Group B streptococcal infection[J]. Pediatr Infect Dis, 1985, 4(2): 145-148.
[4]
Dandona P, Nix D, Wilson MF, Aljada A, Love J, Assicot M, et al. Procalcitonin increase after endotoxin injection in normal subjects[J]. J Clin Endocrinol Metab, 1994, 79(6): 1605-1608.
[5]
Yu Z, Liu J, Sun Q, Qiu Y, Han S, Guo X. The accuracy of the procalcitonin test for the diagnosis of neonatal sepsis: a meta-analysis[J]. Scand J Infect Dis, 2010, 42(10): 723-733.
[6]
Benitz WE. Adjunct laboratory tests in the diagnosis of early-onset neonatal sepsis[J]. Clin Perinatol, 2010, 37(2): 421-438.
Franz AR, Steinbach G, Kron M, Pohlandt F. Reduction of unnecessary antibiotic therapy in newborn infants using interleukin-8 and C-reactive protein as markers of bacterial infections[J]. Pediatrics, 1999, 104(3): 447-453.
Abdollahi A, Shoar S, Nayyeri F, Shariat M. Diagnostic value of simultaneous measurement of procalcitonin, interleukin-6 and hs-CRP in prediction of early-onset neonatal sepsis[J/OL]. editerr J Hematol Infect Dis, 2012, 4(1): e2012028. doi: 10.4084/MJHID.2012.028.
