[Bacterial pneumopathies of the newborn: diagnostic and therapeutic aspects]

To describe the diagnosis and therapeutic management of bacterial pneumopathies in a neonatology unit located in a tropical area.

Transverse and prospective survey over an 18-month period. The diagnosis was based on the comparison of anamnestic features with clinical, biological and radiological features. A research was made in order to determine the causal agent in the blood, in cerebrospinal fluid, in urines, in pleural liquid and skin lesions. A treatment by two antibiotics was administered through parenteral route.

Risk factors were found in 61 selected patients. Polypnea was associated with signs of respiratory distress in 53 patients. Blood abnormalities were present in 47, 5% of the cases. All the patients showed a positive C reactive protein and abnormal X-rays. The diagnosis was confirmed bacteriologically in 32, 8% of the cases. The association of a third-generation cephalosporin with an aminoside was prescribed in 44 cases. The initial antibiotic therapy was not relevant in 19, 7% of the cases. The lethality rate was 24, 6%. The scarcity of bacteriological confirmation led us to consider the combination of radiological abnormalities with respiratory distress as significant symptoms of bacterial pneumopathy. Biological and anamnestic features were considered as extra elements.

The severity of clinical features, the nature of germs and their sensitivity to antibiotics in our local environment led us to recommend a large prescription of third-generation cephalosporins combined to aminoglycosides.