title: Prophylactic antibiotics to reduce morbidity and mortality in newborn infants with intercostal catheters.
abstract: BACKGROUND
  Intercostal catheters are commonly used for the drainage of intrathoracic collections in newborn infants, including pneumothorax and pleural effusions. Placement of an intercostal drain is a potential risk factor for nosocomial infection due to breach of the cutaneous barrier. Therefore, neonates who require intercostal drainage, especially those in high risk groups for nosocomial infection, may benefit from antibiotic prophylaxis. However, injudicious antibiotic use carries the risk of promoting the emergence of resistant strains of micro-organisms or of altering the pattern of pathogens causing infection.
  
  
  OBJECTIVE
  To determine the effect of prophylactic antibiotics compared to selective use of antibiotics on mortality and morbidity (especially septicaemia) in neonates undergoing placement of an intercostal catheter.
  
  
  METHODS
  The standard search strategy of the Cochrane Neonatal Review Group was used to search the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 5), MEDLINE (1948 to June 2011) and CINAHL (1982 to June 2011).
  
  
  METHODS
  Randomised controlled trials or some types of non-randomised (that is, quasi-randomised) controlled trials of adequate quality in which either individual newborn infants or clusters of infants were randomised to receive prophylactic antibiotics versus placebo or no treatment.
  
  
  METHODS
  We used the standard methods of the Cochrane Neonatal Review Group.
  
  
  RESULTS
  We did not find any randomised controlled trials that met the eligibility criteria.
  
  
  CONCLUSIONS
  There are no data from randomised trials to either support or refute the use of antibiotic prophylaxis for intercostal catheter insertion in neonates. Any randomised controlled trials of antibiotic prophylaxis would need to account for the fact that neonates who require insertion of an intercostal catheter may already be receiving antibiotics for other indications.
authors.affiliation: Monash Newborn, Monash Medical Centre, Clayton, Australia. AliceE.Stewart@southernhealth.org.au.
authors.forename: Alice
authors.initials: A
authors.lastname: Stewart
authors.forename: Garry D T
authors.initials: GD
authors.lastname: Inglis
authors.forename: Luke A
authors.initials: LA
authors.lastname: Jardine
authors.forename: Pieter
authors.initials: P
authors.lastname: Koorts
authors.forename: Mark W
authors.initials: MW
authors.lastname: Davies
mesh_terms: D019072:Antibiotic Prophylaxis; D015505:Chest Tubes / Q000009:adverse effects*; D003428:Cross Infection / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D007231:Infant, Newborn; D018805:Sepsis / Q000517:prevention & control*