Related Experiment Video

Updated: May 6, 2026

Application of an Amplitude-integrated EEG Monitor Cerebral Function Monitor to Neonates
05:58

Application of an Amplitude-integrated EEG Monitor Cerebral Function Monitor to Neonates

Published on: September 6, 2017

41.6K

Outcomes of early-phase ampicillin plus aminoglycosides versus ampicillin plus cefotaxime for preterm infants

Hiroki Kitaoka1, Takaaki Konishi2,3, Yoshihiko Shitara4,5

  • 1Department of Pediatrics, The University of Tokyo Hospital, Tokyo, Japan. kitaokahir@m.u-tokyo.ac.jp.

Pediatric Research
|May 4, 2026
PubMed

Insights

Early empirical ampicillin plus aminoglycosides and ampicillin plus cefotaxime showed similar mortality in preterm infants. However, ampicillin plus aminoglycosides were associated with fewer morbidities and lower hospitalization costs.

Area of Science:

  • Neonatal Medicine
  • Pediatric Infectious Diseases
  • Clinical Pharmacology

Background:

  • Ampicillin plus aminoglycosides may be more effective than ampicillin plus cefotaxime for early empirical antibiotic treatment in preterm infants.
  • This study compares in-hospital outcomes between these two early empirical antibiotic regimens.

Purpose of the Study:

  • To compare in-hospital mortality and major morbidities in preterm infants receiving early empirical ampicillin + aminoglycoside versus ampicillin + cefotaxime.
  • To analyze subgroup outcomes for infants born at less than 28 weeks' gestation.

Main Methods:

  • A retrospective nationwide database study of preterm infants (<35 weeks' gestation) hospitalized between July 2010 and March 2022.
  • Utilized 2:1 propensity score matching to compare outcomes between ampicillin + aminoglycoside (n=33,204) and ampicillin + cefotaxime (n=12,158) groups.
  • Conducted subgroup analyses for infants <28 weeks' gestation.

Main Results:

  • No significant difference in overall in-hospital mortality or hearing impairment incidence between the two groups after propensity score matching.
  • Ampicillin + aminoglycoside group showed significantly lower incidence of bronchopulmonary dysplasia, retinopathy of prematurity, and hospitalization costs.
  • In infants <28 weeks' gestation, ampicillin + aminoglycoside was associated with a lower incidence of hearing impairment.

Conclusions:

  • Early empirical ampicillin + aminoglycoside and ampicillin + cefotaxime therapies demonstrate similar in-hospital mortality rates in preterm infants.
  • The choice of early empirical antibiotics should be guided by local antimicrobial resistance patterns and consideration of regimen-specific morbidities.
  • Ampicillin plus aminoglycosides may offer advantages in reducing specific morbidities and healthcare costs compared to ampicillin plus cefotaxime.
Abstract

More Related Videos

Clinical Practice Protocol of Creative Music Therapy for Preterm Infants and Their Parents in the Neonatal Intensive Care Unit11:50

Clinical Practice Protocol of Creative Music Therapy for Preterm Infants and Their Parents in the Neonatal Intensive Care Unit

Published on: January 7, 2020

28.6K
A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis08:46

A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis

Published on: August 12, 2020

5.5K

Related Concept Videos

Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
859
Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence01:22

Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence

Generic intravenous (IV) drugs are considered bioequivalent to their branded counterparts due to their 100% bioavailability upon administration. However, variations in stability among different drug products can significantly influence their therapeutic performance, even if they are pharmaceutically equivalent.Cefuroxime, a prophylactic antimicrobial, is often used as a single-dose IV injection for patients undergoing coronary artery bypass grafting surgery. A 3 g dose typically provides...
260
Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations01:15

Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations

Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...
386
Inhibitors of Bacterial Protein Synthesis01:25

Inhibitors of Bacterial Protein Synthesis

Aminoglycosides constitute a highly potent class of bactericidal antibiotics that exert their antimicrobial effects by targeting the bacterial ribosome, specifically disrupting protein synthesis. These polycationic molecules consist of amino-modified sugars linked via glycosidic bonds to an aminocyclitol core such as 2-deoxystreptamine or streptamine. Their strong positive charges facilitate tight binding to the negatively charged phosphate backbone of ribosomal RNA (rRNA), primarily at the 16S...
127
Development of the Oral Microbiota01:28

Development of the Oral Microbiota

The establishment of the oral microbiome begins before birth, challenging the long-held belief that the fetal oral cavity is sterile. The presence of oral microbes such as Streptococcus and Fusobacterium in amniotic fluid suggests that microbial exposure may occur in utero, potentially through translocation from the maternal oral or gastrointestinal tract. This early colonization primes the neonatal immune system and sets the stage for subsequent microbial succession. Maternal health,...
73
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
413