The value of surveillance cultures on neonatal intensive care units

Jolley, Alan

doi:10.1016/0195-6701(93)90033-v

Cited by 29 publications

(11 citation statements)

References 18 publications

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“…5 It is likely that the interaction of several factors, such as the host, therapeutic, environmental and microbial all contribute to the colonization of sick babies. 11 So, it becomes prudent to take measures that reduce the multidrug resistant pathogens including ESβL producing K. pneumoniae in the environment of the NICU. One of the important aspects of these measures is to restrict the widespread use of broad-spectrum cephalosporins for empiric therapy.…”

Section: Discussionmentioning

confidence: 99%

Extended Spectrum β Lactamase producing Klebsiella pneumoniae in neonatal intensive care unit

2007

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Widespread use of third generation cephalosporins as a pre-emptive antibiotic for suspected cases of septicaemia may have contributed to emergence of ESbetaL producing K. pneumoniae in addition to other risk factors. ESbetaL producing K. pneumoniae have extensively colonised the environment of the NICU. Transmission of these pathogens to the neonates has probably occurred through the healthcare workers. Efforts to improve hand hygiene among the healthcare workers and mothers are urgently needed.

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Section: Discussionmentioning

confidence: 99%

Extended Spectrum β Lactamase producing Klebsiella pneumoniae in neonatal intensive care unit

2007

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“…22 Furthermore, the excessive use of broad-spectrum antibiotics is an ongoing problem for intensive care nurseries, 26 with increased risk of overgrowth of natural microbial flora with pathogens. [26][27][28] Accordingly, the final part of this study involved the development of alternative dosing strategies that could provide adequate antimicrobial efficacy but lessen exposure to unnecessarily high concentrations. Bayesian predictions of serum amoxicillin concentrations over time from different combinations of doses and dosing intervals in infants of varying weight were obtained in NONMEM using the parameter values from the final model.…”

Section: Discussionmentioning

confidence: 99%

Population Pharmacokinetics of Intravenous Amoxicillin in Very Low Birth Weight Infants

Charles¹,

Preechagoon²,

Lee³

et al. 1997

Journal of Pharmaceutical Sciences

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The population pharmacokinetics of amoxicillin were determined in 40 very premature infants (< or = 32 week gestational age, < 1500 g birth weight) who were receiving intravenous amoxicillin (50 mg/ kg, every 12 h) during the first days after birth. Serum amoxicillin concentrations were measured by HPLC. Clearance (CL) and volume of distribution (Vd) were modeled alone and under the influence of demographic and clinical covariates with a 1-compartment model with first-order elimination. The final population models with influential covariates were: CL(L/h) = 0.0000610 x body weight (g) and CL (L/h) = 0.0000805 x body weight (g), for infants also receiving gentamicin and not receiving gentamicin, respectively; Vd(L) = 0.678. The interpatient standard deviation (SD) for CL was 0.0351 L/h, and for Vd was 0.365 L. The intrapatient variability (SD) among observed and model-predicted serum concentrations was 13.7 mg/L. Evaluation of the predictive performance of this model in another group of infants (n = 16) indicated statistically insignificant bias (p > 0.05) of 3 mg/L among pairs of observed and Bayesian-predicted amoxicillin concentrations. The average population CL was smaller, but the average Vd and terminal half-life (t1/2) were larger than previously reported for healthy adults.

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“…20 In retrospect, it appears likely that the antibiotics that our patient received contributed to the development of her fungal and multidrug-resistant bacterial infections. Although treatment appeared indicated at the time, our experience demonstrates that empiric antibiotic therapy is not without risk.…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Late-Onset Infection due to Resistant Klebsiella pneumoniae in an Extremely Low Birth Weight Infant Using Ciprofloxacin

et al. 1999

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The value of surveillance cultures on neonatal intensive care units

Cited by 29 publications

References 18 publications

Extended Spectrum β Lactamase producing Klebsiella pneumoniae in neonatal intensive care unit

Extended Spectrum β Lactamase producing Klebsiella pneumoniae in neonatal intensive care unit

Population Pharmacokinetics of Intravenous Amoxicillin in Very Low Birth Weight Infants

Successful Treatment of Late-Onset Infection due to Resistant Klebsiella pneumoniae in an Extremely Low Birth Weight Infant Using Ciprofloxacin

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