title: Different antibiotic strategies in transient tachypnea of the newborn: an ambispective cohort study.
abstract: The purpose of this study is to determine the outcome and infection-related events in neonates with transient tachypnea of the newborn (TTN) managed with an antibiotic initiation strategy. An ambispective cohort study was carried out to compare two different antibiotic strategies in of TTN patients. The first strategy is based on clinical risk evaluation, in which antibiotics are initiated according to clinical signs, while the other is a combined strategy that integrates information regarding clinical signs, perinatal risk factors, and lab-based surveillance of infectious indicators. The antibiotic use in the combined strategy group (n = 716) was lower than that of the control group (n = 769) (35.06 vs 54.75 %, P < 0.01). Outcomes including total duration of antibiotic therapy (5.45 ± 4.17 vs 5.18 ± 3.45 days, P = 0.36), mortality (0 vs 0), length of hospital stay (7.78 ± 4.20 vs 8.14 ± 3.62 days, P = 0.07), and hospital readmission (4.89 vs 4.94 %, P = 0.94) did not differ; nor did infection-related events such as nosocomial infection (2.93 vs 2.99 %, P = 0.95), infectious pneumonia (18.30 vs 19.90 %, P = 0.43), septicemia (1.96 vs 1.95 %, P = 0.99), and necrotizing enterocolitis (0.14 vs 0.26 %).
  
  
  CONCLUSIONS
  The combined strategy effectively reduces antibiotic usage during incidences of TTN with no negative impact on the clinical outcome.
  
  
  BACKGROUND
  • TTN is easy to be confused with infection only based on clinical signs. • Many TTN patients had been treated with unnecessary antibiotics.
  
  
  BACKGROUND
  • Our combined strategy for TTN can reduce antibiotics usage. • New strategy did not increase the incidence of infection and adverse outcomes.
authors.affiliation: Department of Pediatrics, West China Second University Hospital, Sichuan University, No. 20 3rd Section of South Ren Ming Road, Chengdu, 610041, Sichuan, People's Republic of China, yoyolee824@163.com.
authors.forename: Jinhui
authors.initials: J
authors.lastname: Li
authors.forename: Jinlin
authors.initials: J
authors.lastname: Wu
authors.forename: Lizhong
authors.initials: L
authors.lastname: Du
authors.forename: Yong
authors.initials: Y
authors.lastname: Hu
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Yang
authors.forename: Dezhi
authors.initials: D
authors.lastname: Mu
authors.forename: Bin
authors.initials: B
authors.lastname: Xia
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007239:Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D059245:Transient Tachypnea of the Newborn / Q000150:complications* / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents
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