title: The use of piperacillin/tazobactam (in association with amikacin) in neonatal sepsis: efficacy and safety data.
abstract: Piperacillin/tazobactam (P/T) has been used in NICU since 1999 as part of the empirical treatment for presumed sepsis. We studied the microbiological and clinical efficacy and safety of P/T use in newborns with sepsis, using a retrospective analysis of medical records of all newborns treated with P/T (in association with amikacin) during 1999-2003. P/T plus amikacin was used for 353 episodes of presumed sepsis occurring in 252 newborns: 105 episodes occurred in 100 newborns treated for 5-14 d while in 248 (70%) episodes the treatment was discontinued after 2-3 d. 123 pathogens were isolated from the blood cultures (40 in the 5-14 d group and 83 in those treated for 2-3 d only). There were 56 Gram-negative, 55 Gram-positive and 12 Candida spp. isolates. Klebsiella spp. (40%) and E. coli (30%) were the most commonly isolated Gram-negative pathogens; coagulase-negative Staphylococcus (CONS) represented 95% of the Gram-positive pathogens isolated. Pathogen eradication was achieved within 48-72 h of therapy in 93% Gram-negative organisms. There were no clinical, laboratory or cranial ultrasound adverse effects associated with P/T use. We conclude that P/T in association with amikacin is microbiologically and clinically efficacious and safe in the treatment of sepsis in newborns.
authors.affiliation: Department of Neonatology, Kaplan Medical Center, Rehovot, Hebrew University, Jerusalem, Israel. orna_f@clalit.org.il
authors.forename: Orna
authors.initials: O
authors.lastname: Flidel-Rimon
authors.forename: Smadar
authors.initials: S
authors.lastname: Friedman
authors.forename: Eugene
authors.initials: E
authors.lastname: Leibovitz
authors.forename: Eric S
authors.initials: ES
authors.lastname: Shinwell
mesh_terms: D000583:Amikacin / Q000009:adverse effects* / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D004359:Drug Therapy, Combination; D006090:Gram-Negative Bacteria / Q000187:drug effects; D006094:Gram-Positive Bacteria / Q000187:drug effects; D006801:Humans; D007231:Infant, Newborn; D010397:Penicillanic Acid / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D010878:Piperacillin / Q000009:adverse effects / Q000627:therapeutic use; D000077725:Piperacillin, Tazobactam Drug Combination; D012189:Retrospective Studies; D018805:Sepsis / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D000077725:Piperacillin, Tazobactam Drug Combination; D000583:Amikacin; D010397:Penicillanic Acid; D010878:Piperacillin