In order to assess the potential fo procalcitonin measurement in the management of neonatal sepsis, daily variations in serum procalcitonin (measured by an immunoluminometric assay) were evaluated in 94 control and infected newborn infants in comparison to C-reactive protein (measured by an immunonephelometric method). High levels of procalcitonin correlated with bacterial invasion and showed no discrepancies with C-reactive protein. procalcitonin increased (up to 400 micrograms l-1 and returned to the normal range (< 0.1 microgram l-1) more quickly than C-reactive protein, suggesting that procalcitonin may be an early marker of favourable outcome. Another finding is a significant procalcitonin peak on the first day of life in the control group, independent of any infectious stimulus. In conclusion, procalcitonin seems to be an interesting marker of neonatal sepsis but additional investigations are needed to understand better its mechanism of synthesis in order to determine its clinical usefulness.

Infants fed formulas containing probiotics or synbiotics show a similar rate in weight gain compared with those fed a control formula and tolerate these formulas well.

) Correspondence the blood and tissues following therapy with foscarnet supports the antiviral potency of this agent in a clinical setting.Serologies for HHV-8 are currently available in the research setting [4]. Once quantitative PCR results and standardized serologies become available in practice, we believe that it will be useful to screen high-risk patients for HHV-8 infection so that therapies that prevent the development and progression of KS may be instituted. We, furthermore, question whether cytotoxic chemotherapy will remain a mainstay of therapy. Prospective trials should clarify the optimal treatment modality for KS as well as the most useful agent against HHV-8 in vivo. In conclusion, and whatever the mechanism of synthesis, procal- Sepsis in Neonatescitonin serum values must be interpreted with caution in newborns. Although procalcitonin remains a promising marker for the diagno-SIR-We have been interested in the recent paper by Chiesa and sis of sepsis as described by Chiesa et al., high serum procalcitonin colleagues that demonstrated the usefulness of procalcitonin mealevels are clearly not necessarily indicative of bacterial infection surement for the diagnosis of early-and late-onset sepsis in neoin neonates. nates at risk for bacterial infection [1]. This work clearly confirms and extends our results reported in a previous study [2]. NevertheGuillaume Monneret, Jean Marc Labaune, Christian Isaac, less, we concluded in our article that false-positive results could Françoise Bienvenu, Guy Putet, and Jacques Bienvenu be observed in uninfected newborns with respiratory distress synNeonatal Intensive Care Unit and Immunology Laboratory, Hôpital drome (RDS). This has also been reported by Lapillonne et al.

Amikacin is widely used in the treatment of suspected or confirmed neonatal infections. However, dosage regimens are not well defined in this group of patients because of a wide inter-individual pharmacokinetic variability. An individualized goal-oriented amikacin dosage design was applied using population pharmacokinetic data. A dosing chart was developed for neonates during the first 2 days of life, by using population pharmacokinetic parameter values and USCPACK software. This dosing chart based on gestational age (GA) and body weight gives a once-a-day amikacin dosage regimen involving an injection every 24 h. Validation was performed in 57 neonates less than 2 days old, divided into three GA groups and prospectively treated using the dosing chart. Target peak serum levels of amikacin were obtained in 62–80% of patients after the first dose and in 80–100% after the second dose, and trough concentrations were obtained in 100%. This study has confirmed the need for individualization of amikacin dosage regimens in neonates.

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