Late-onset infection and the role of antibiotic prescribing policies.

Abstract

PURPOSE OF REVIEW:

Late-onset infection is a significant cause of morbidity and mortality in low-birth-weight and premature infants. Empirical antibiotic treatment is used as infants can deteriorate rapidly without treatment. Current data on the epidemiology of late-onset infection, the types of antibiotics used, duration of antibiotic use, and antibiotic prescribing policies are reviewed.

RECENT FINDINGS:

Epidemiological data on late-onset sepsis is dominated by information concerning developed countries; large prospective data collections have been set up in many such countries. Recent data indicate that late-onset sepsis occurs in one-fifth of very-low-birth-weight infants. There are increasing concerns regarding antibiotic resistance. Antibiotic regimens that do not include third-generation cephalosporins produce less resistance. Strategies of antibiotic rotation have not been documented as producing a marked effect on the development of resistant micro-organisms, but there is a lack of randomized trials. Recommendations for preventing the spread of vancomycin-resistant enterococci, produced by the Hospital Infection Control Practices Advisory Committee, have been shown to be effective in a number of situations. Recent reports have documented the success of multidisciplinary, systems-orientated approaches for reducing neonatal nosocomial infection.

SUMMARY:

Antibiotic prescribing policies have an important role to play in the treatment of late-onset neonatal infection. There is enough evidence to state that narrow-spectrum antibiotics should be used wherever possible and that potent broad-spectrum antibiotics should be kept in reserve. Ongoing prospective surveillance of infection rates, micro-organisms, resistance and antibiotic use is essential.

• Authors: Adrienne Gordon, David Isaacs
• Journal: Current opinion in infectious diseases (Curr Opin Infect Dis) Vol. 17 Issue 3 Pg. 231-6 (Jun 2004) ISSN: 0951-7375 [Print] United States
• PMID: 15166826 (Publication Type: Journal Article)

Chemical References

• Anti-Bacterial Agents

Topics

• Anti-Bacterial Agents (therapeutic use)
• Bacterial Infections (drug therapy, epidemiology, microbiology)
• Cross Infection (drug therapy, epidemiology)
• Drug Resistance, Bacterial
• Humans
• Infant
• Infant, Newborn
• Infant, Premature
• Infant, Premature, Diseases (drug therapy, epidemiology, microbiology)
• Infant, Very Low Birth Weight
• Time Factors