Quality of life (QoL) was assessed in 85 young adults, born in 1971-1974 with birthweights < 1500 g (VLBW) and admitted to the neonatal intensive care unit of the State University Hospital in Copenhagen, Denmark. Their QoL was compared to that of 85 subjects with birthweights > 2500 g (NBW) born in the same period at the State University Hospital. The subjects were interviewed by telephone on the basis of the well-defined theories on QoL by Anton Aggernaes. Quality of life was assessed both in objective terms and as judged by the interviewed person. Subjects born with VLBWs and free of handicaps had QoL scores (both objective and subjective) fully comparable with the NBW group. VLBW subjects reporting various physical and mental handicaps had objective as well as subjective QoL scores significantly lower than the NBW group.

Background: Nasal continuous positive airway pressure (nCPAP) stabilizes the residual volume and may decrease the risk of ‘atelectotrauma', potentially promoting lung development in neonates. Objectives: To assess whether replacing nCPAP by low-flow O₂ by nasal cannula affects lung function expressed as the arterial/alveolar oxygen tension ratio (a/A pO₂ ratio) on postnatal day 28. Methods: Preterm infants (birth weight <1,500 g and gestational age, GA >26 + 0 weeks) stable on nCPAP between postnatal days 4 and 7 were randomized to nCPAP or low-flow O₂ by nasal cannula (<0.2 liters/min). Study criteria defined how to wean/restart respiratory support or change from low-flow O₂ to nCPAP and vice versa. Transcutaneous monitoring was used for the assessment of the a/A pO₂ ratio on day 28 using a head box for all infants for accurate measurement and to eliminate possible effects from nCPAP or low-flow O₂ on oxygen requirement. Results: We enrolled 52 infants (nCPAP group n = 30 and low-flow O₂ group n = 22). The a/A pO₂ ratio at 28 days was 0.43 ± 0.17 (nCPAP group) versus 0.48 ± 0.18 (p = 0.36). The duration of nCPAP was 16.4 (low-flow group) versus 41.1 days (nCPAP group), p < 0.001. There was no difference between groups in the fraction needing any respiratory support at 36 weeks' corrected age, length of stay, weight at discharge, and relative weight gain. Conclusions: Replacing nCPAP by low-flow O₂ in preterm infants with GA >26 weeks at the end of the first week of life did not seem to affect the a/A pO₂ ratio or weight gain negatively. Thus, prolonged nCPAP seems not to have a positive effect on lung function at 28 days of life and replacement by low-flow O₂ could reduce the cost of equipment and increase the ease of nursing.

LNB can present as acute ocular motor disorders in conjunction with fatigue and other clinical manifestations. In endemic areas, children with unexplained, acquired ocular motor abnormalities should be evaluated for LNB, a treatable medical condition.

The process is time-consuming as studies are lacking and age-appropriate dosage forms and concentrations differ amongst countries. Nevertheless, the process should be somewhat similar between countries, albeit different drugs may be selected for the final formulary lists.

ObjectiveTo evaluate the implementation of switch from intravenous-to-oral antibiotic therapy with amoxicillin in neonates with early-onset infection (EOI).Design, setting and patientsA population-based multicentre cohort study. All term-born neonates with EOI were prospectively included between 1 December 2018 to 30 November 2020.InterventionIntravenous-to-oral switch antibiotic therapy in clinically stable neonates.Main outcome measuresThe primary outcome was readmission due to infection. Secondary outcomes were days of hospitalisation and antibiotic use in the pre-implementation versus post implementation period.ResultsDuring 2 years, 835 neonates commenced antibiotics for EOI (1.5% (95% CI 1.4% to 1.6%)) of all term live births). Of those, 554 (66%) underwent a full course of treatment. There were 23 episodes of culture-proven infection (0.42 per 1000 term live births (95% CI 0.27 to 0.63)). A total of 478 of 531 (90%) neonates with probable infection underwent switch therapy. None was readmitted due to infection. The median duration of hospitalisation was 3.0 days (IQR 2.5–3.5) and 7.4 days (IQR 7.0–7.5) in the switch and intravenous therapy groups, respectively. According to antibiotic surveillance data, 1.2% underwent a full course of treatment following implementation of oral switch therapy (2019–2020), compared with 1.2% before (2017–2018).ConclusionIn clinical practice, switch therapy was safe and used in 9 of 10 neonates with probable EOI. Knowledge of the safety of antibiotic de-escalation is important as home-based oral therapy ameliorates the treatment burden for neonates, caregivers and healthcare systems. Despite the ease of oral administration, implementation of switch therapy did not increase the overall use of antibiotics.