Predictors of gentamicin therapy failure in neonates with sepsis.
Pharmacol Res Perspect
; 12(4): e1250, 2024 Aug.
Article
en En
| MEDLINE
| ID: mdl-39105353
ABSTRACT
Sepsis is a common disease with high morbidity and mortality among newborns in intensive care units world-wide. Gram-negative bacillary bacteria are the major source of infection in neonates. Gentamicin is the most widely used aminoglycoside antibiotic in empiric therapy against early-onset sepsis. However, therapy failure may result due to various factors. The purpose of this study was to identify predictors of gentamicin therapy failure in neonates with sepsis. This was a prospective cross-sectional study at the Neonatal Intensive Care Unit at Windhoek Central Hospital over a period of 5 months in 2019. Neonates received intravenous gentamicin 5 mg/kg/24 h in combination with either benzylpenicillin 100 000 IU/kg/12 h or ampicillin 50 mg/kg/8 h. Logistic regression modeling was performed to determine the predictors of treatment outcomes. 36% of the 50 neonates were classified as having gentamicin treatment failure. Increasing treatment duration by 1 day resulted in odds of treatment failure increasing from 1.0 to 2.41. Similarly, one unit increase in CRP increases odds of gentamicin treatment failure by 49%. The 1 kg increase in birthweight reduces the log odds of treatment failure by 6.848, resulting in 99.9% decrease in the odds of treatment failure. One unit increase in WBC reduces odds of gentamicin treatment failure by 27%. Estimates of significant predictors of treatment failure were precise, yielding odds ratios that were within 95% confidence interval. This study identified the following as predictors of gentamicin therapy failure in neonates prolonged duration of treatment, elevated C-reactive protein, low birthweight, and low white blood cell count.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Gentamicinas
/
Unidades de Cuidado Intensivo Neonatal
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Insuficiencia del Tratamiento
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Antibacterianos
Límite:
Female
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Humans
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Male
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Newborn
Idioma:
En
Revista:
Pharmacol Res Perspect
Año:
2024
Tipo del documento:
Article
País de afiliación:
Namibia
Pais de publicación:
Estados Unidos