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与新生儿长期抗生素治疗相关的因素 新生儿怀疑早期发作的败血症
Bo M van der Weijden1,2, Jolien R van Dorth1, Niek B Achten3
1Department of Paediatrics, Tergooi MC, Laan van Tergooi 2, 1212 VG Hilversum, The Netherlands.
Antibiotics (Basel, Switzerland)
|May 24, 2024
概括
延长抗生素治疗疑似早期发作的败血症 (EOS) 在新生儿与阴性血培养是常见的. 临床原因通常依赖于主观评估,而不是客观指导方针.
科学领域:
- 新生儿医学 新生儿医学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 早期发作的败血症 (EOS) 是新生儿的一种关键性细菌感染.
- 虽然经验性抗生素治疗至关重要,但尽管血液培养结果呈阴性,但其持续存在挑战.
- 减少不必要的抗生素暴露对于打击抗菌素耐药性至关重要.
研究的目的:
- 确定与新生儿长期抗生素治疗相关的因素,怀疑EOS和阴性血液培养.
- 分析临床医生报告的继续抗生素治疗的原因.
- 评估是否遵守停止使用抗生素的指南.
主要方法:
- 回顾性单中心队列研究.
- 包括2019年1月至2021年6月期间入院的妊娠年龄≥32周的新生儿.
- 基于母体,临床和实验室数据,比较长期 (≥3天) 与暂停 (<3天) 抗生素治疗的新生儿.
主要成果:
- 35.9%的阴性血液培养的新生儿接受了长时间的抗生素治疗.
- 长期治疗与更高的妊娠年龄和更少的自发早产有关.
- 延长时间的临床原因包括临床外观 (38.3%) 和升高的CRP水平 (36.2%),通常是主观的.
结论:
- 在怀疑EOS的经验性抗生素的延续与负面培养是普遍存在的.
- 影响延长的因素往往是主观的,没有指导方针支持.
- 需要客观的标准来指导新生儿使用抗生素的持续时间.
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