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Related Experiment Videos

Piperacillin in early neonatal infection.

M Placzek, A Whitelaw, S Want

    Archives of Disease in Childhood
    |December 1, 1983
    PubMed
    Summary

    Piperacillin and flucloxacillin effectively treated early bacterial infections in newborns. While generally safe, critically ill infants with neutropenia or meningitis may require a second antibiotic due to potential E. coli resistance.

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    Area of Science:

    • Neonatal Medicine
    • Infectious Diseases
    • Pharmacology

    Background:

    • Neonatal bacterial infections pose a significant threat in the first 48 hours of life.
    • Effective antibiotic regimens are crucial for combating early-onset sepsis in neonates.

    Purpose of the Study:

    • To evaluate the efficacy and safety of piperacillin and flucloxacillin versus penicillin and gentamicin for treating suspected bacterial infections in neonates.
    • To assess piperacillin pharmacokinetics, including serum and cerebrospinal fluid concentrations and half-life, in neonates.

    Main Methods:

    • A comparative study involving 70 neonates with suspected bacterial infection.
    • Treatment groups received either piperacillin/flucloxacillin or penicillin/gentamicin.
    • Pharmacokinetic parameters of piperacillin were measured, including serum and CSF levels and half-life.

    Main Results:

    • Piperacillin and flucloxacillin successfully eradicated confirmed infections in 6 out of 35 infants.
    • Penicillin and gentamicin treated 4 infants with confirmed infections; one initially deteriorated but recovered with piperacillin.
    • Therapeutic piperacillin concentrations were achieved in serum and CSF, with a median half-life of 6.5 hours, prolonged in renal impairment.

    Conclusions:

    • Piperacillin is a safe and effective first-line treatment for early neonatal infections.
    • Combination therapy may be necessary for critically ill neonates with neutropenia or meningitis due to potential resistance in some Escherichia coli strains.

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