TY - JOUR
T1 - Pneumonia in term neonates
T2 - Laboratory studies and duration of antibiotic therapy
AU - Engle, William D.
AU - Jackson, Gregory L.
AU - Sendelbach, Dorothy M.
AU - Stehel, Elizabeth K.
AU - Ford, Diane M.
AU - McHugh, Kathleen M.
AU - Norris, Margienetta R.
AU - Vedro, Debra A.
AU - Velaphi, Sithembiso
AU - Michelow, Ian C.
AU - Olsen, Kurt D.
N1 - Funding Information:
Funding was provided in part by the General Clinical Research Center, the University of Texas Southwestern Medical Center, Dallas, Texas (USPHS Grant # M01-RR00633).
PY - 2003/8
Y1 - 2003/8
N2 - Objectives: To compare 2 days of antibiotic therapy (AT) to 4 days of AT in neonates with pneumonia and to assess the usefulness of neutrophil values (NV), C-reactive protein (CRP), and procalcitonin (PCT) in this population. Design: The study population consisted of consecutive, eligible term neonates begun on AT for suspected pneumonia. Of 51 neonates, 26 qualified for randomization (14, 2-day group; 12, 4-day group). NV were obtained with the initial evaluation and 12 and 24 hours later. CRP and PCT were obtained 12 and 48 hours after the initial evaluation. Results: None of the 12 neonates in the 4-day group developed recurrent respiratory symptoms. Three of the 14 neonates randomized to the 2-day group had recurrence of symptoms, resulting in study termination. NV, CRP, and PCT were similar in the 2- and 4-day groups. In the three neonates who developed respiratory symptoms, all absolute total neutrophil values and five out of nine absolute total immature neutrophil values were abnormal. However, all immature:total neutrophil values were normal, and CRP was strikingly elevated in only one neonate; only one of six PCT values was abnormal. In a secondary analysis of all 51 study neonates, CRP and PCT did not provide additional benefit over NV in differentiating neonates with pneumonia. Conclusions: Four days of AT appears to be adequate for selected term neonates with pneumonia; however, 2 days of AT appears to be inadequate for this population. Relative to NV, CRP and PCT appear to have a limited role.
AB - Objectives: To compare 2 days of antibiotic therapy (AT) to 4 days of AT in neonates with pneumonia and to assess the usefulness of neutrophil values (NV), C-reactive protein (CRP), and procalcitonin (PCT) in this population. Design: The study population consisted of consecutive, eligible term neonates begun on AT for suspected pneumonia. Of 51 neonates, 26 qualified for randomization (14, 2-day group; 12, 4-day group). NV were obtained with the initial evaluation and 12 and 24 hours later. CRP and PCT were obtained 12 and 48 hours after the initial evaluation. Results: None of the 12 neonates in the 4-day group developed recurrent respiratory symptoms. Three of the 14 neonates randomized to the 2-day group had recurrence of symptoms, resulting in study termination. NV, CRP, and PCT were similar in the 2- and 4-day groups. In the three neonates who developed respiratory symptoms, all absolute total neutrophil values and five out of nine absolute total immature neutrophil values were abnormal. However, all immature:total neutrophil values were normal, and CRP was strikingly elevated in only one neonate; only one of six PCT values was abnormal. In a secondary analysis of all 51 study neonates, CRP and PCT did not provide additional benefit over NV in differentiating neonates with pneumonia. Conclusions: Four days of AT appears to be adequate for selected term neonates with pneumonia; however, 2 days of AT appears to be inadequate for this population. Relative to NV, CRP and PCT appear to have a limited role.
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U2 - 10.1038/sj.jp.7210949
DO - 10.1038/sj.jp.7210949
M3 - Article
C2 - 12847531
AN - SCOPUS:0043198059
SN - 0743-8346
VL - 23
SP - 372
EP - 377
JO - Journal of Perinatology
JF - Journal of Perinatology
IS - 5
ER -