Abstract
Objectives: The aim of this study is to determine the efficacy of administrating antibiotics to prevent central catheter-related infections in newborns (NW).
Methods: We report a survey of 122 patients of our Neonatal Unit over a two years period. Criteria for inclusion: at least 24 weeks gestation or 500 grams, no mortal congenital malformations, catheter inserted in the first 72 hours after labor, no infection (possible or confirmed), and absence of mechanical ventilation. At the beginning and at the end of the technique, blood is extracted for blood culture. A betalactamic and an aminoglucoside agents are administered intravenously when canalizing the central way, and for 7 days to one of every two newborns. Both groups are compared, not receiving antibiotics (A) and receiving antibiotics (B), evaluating positive cultures and diagnosis of infections. Statistical method: Odds Ratio (OR) and î2 test.
Results: Selected NW: 122. Valid NW for the study: 117 (61 in group A and 56 in group B) Pre-catheterization: NW with positive cultures: Group A: 8. Group B: 7 (OR: 1,06; IC95%: 0,32–3,55) NW with positive blood cultures: Group A: 4. Group B: 3 (OR: 1,22; IC95%: 0,22–7,39) Post-catetherization: NW with positive cultures Group A: 18. Group B: 18 (OR: 0,88; IC95%: 0,37–2,09) NW with positive blood cultures: Group A: 3. Group B: 3 (OR: 0,91; IC95%: 0,14–5,99) NW with infection: Total infections: Group A: 10. Group B: 16 (OR: 0,49; IC95%: 0,18–1,30) 0–7 days: Group A: 5. Group B: 6 (OR: 0,74; IC95%: 0,18–2,98) 7 days: Group A: 5. Group B: 10 (OR: 0,41; IC95%: 0,11–1,43) Sepsis: Group A: 6. Group B: 7 (OR: 0,76; IC95%: 0,21–2,76) 0–7 days: Group A: 3. Group B: 4 (OR: 0,67; IC95%: 0,11–3,78) 7 days: Group A: 3. Group B: 3 (OR: 0,91; IC95%: 0,14–5,99) Other infections: Group A: 4. Group B: 9 (OR: 0,37; IC95%: 0,09–1,42) 0–7 days: Group A: 2. Group B: 2 (OR: 0,92; IC95%: 0,09–9,50) 7 days: Group A: 2. Group B: 7 (OR: 0,24; IC95%: 0,03–1,33)
Conclusion: In our hospital, central cathetherised newborns receiving profilactically antibiotics seem to have a major probability, with no statistical differences, of having more nonseptical and later infections, than those who don't receive antibiotics. There are very few differences in the incidence of sepsis and early infections in both groups. Therefore, it doesn't seem useful the use of profilactical antibiotics when cathetherising a non infected newborn.
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Fernández-Mayoralas, D., Jareño, N., Caballero, J. et al. 179 Neonatal Infection After Central Catheterization, According To Antibiotical Therapy. Pediatr Res 56, 494 (2004). https://doi.org/10.1203/00006450-200409000-00202
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DOI: https://doi.org/10.1203/00006450-200409000-00202