Evaluation of three antibiotic programs in newborn infants

Area of Science:

• Neonatal Pharmacology
• Infectious Diseases
• Critical Care Medicine

Background:

• Rising antibiotic resistance in gram-negative bacteria necessitates exploring alternative antimicrobial strategies.
• Neonatal intensive care units (NICUs) face challenges with infections requiring effective antibiotic combinations.

Purpose of the Study:

• To prospectively evaluate the safety and efficacy of three antibiotic combinations in neonates.
• To compare gentamicin-ampicillin, tobramycin-cephalothin, and amikacin-ampicillin in a neonatal intensive care setting.

Main Methods:

• Sixty newborns were randomly assigned to receive one of the three antibiotic therapy groups.
• Dosages administered were: ampicillin and cephalothin (100 mg/kg/day), gentamicin and tobramycin (6 mg/kg/day), and amikacin (15 mg/kg/day).
• Aminoglycoside serum concentrations, clinical tolerance, and toxicity (hematologic, renal, hepatic) were monitored.

Main Results:

• Achieved aminoglycoside serum concentrations were within the expected therapeutic ranges.
• No significant hematologic, renal, or hepatic toxicity was observed across all treatment groups.
• All antibiotic combinations were equally tolerated, with no detected bilirubin displacement in vitro or in vivo.

Conclusions:

• The evaluated antibiotic combinations (gentamicin-ampicillin, tobramycin-cephalothin, amikacin-ampicillin) are safe for use in neonates.
• These combinations demonstrate comparable tolerance and toxicity profiles, offering viable options for neonatal infections.