1,721,015 research outputs found
Antibiotic Use in a Cohort of Extremely Low Birth Weight Neonates: Focus on Off-Label Uses and Prescription Behaviour
No full textAim: To analyse antibiotic prescriptions in a cohort of extremely low birth weight neonates admitted to Italian level III Neonatal intensive Care Units. Methods: An online questionnaire was used to collect detailed information for each newborn. Antibiotic prescriptions were classified about their license status and compared with British National Formulary for Children (BNFC) and with a practical guide prepared by the Italian Society of Neonatology (ISN). Results: During the study period (May-July 2014) among 93 neonates admitted to 30 Italian Neonatal intensive Care Units, 56 (60%) received at least an antibiotic (92 prescriptions in total). Ampicillin, gentamicin and vancomycin were the antibiotics most commonly used for the prevention/treatment of bacterial infections. 56/92 antibiotic prescriptions (61%) resulted off-label mainly as regards dosing frequency, while 13 prescriptions (14%) regarded antibiotics used in absence of specific indication for newborns (meropenem, imipenem, piperacillin/tazobactam, clindamycin, clarithromycin). 50/56 neonates (89.3%) received at least one off-label antibiotic prescription. Differences have been observed in dosing regimens between current study and recommendations contained in BNFC, while prescriptions adhered more frequently to ISN indications. Conclusions: Our results confirm the high prevalence of off-label antibiotic use in ELBW neonates and underline a better adherence to indications based on clinical practice
Paracetamol (Acetaminophen) Efficacy and Safety in the Newborn
No full textAbstract: Neonates can perceive pain, therefore an adequate analgesic therapy is a major issue not only from an ethical perspective but
also to improve short- and long-term outcome. Fever during the neonatal period requires hospitalization and needs a treatment with an
antipyretic agent because of the high risk of severe complications.
Paracetamol (acetaminophen), the most commonly prescribed drug in paediatric patients for its analgesic and antipyretic effects, is the
only agent recommended for use as an antipyretic in the newborn and has been recently proposed as a supplement therapy to opioids for
postoperative analgesia.
This article aims to give an updated overview on the use of paracetamol in newborns by presenting its pharmacological profile (mechanism
of action, pharmacokinetics), recommendations for dosing regimens (oral or rectal administration: 25-30 mg/kg/day in preterm neonates
of 30 weeks’ gestation, 45 mg/kg/day in preterm neonates of 34 weeks’ gestation, 60 mg/kg/day in term neonates; i.v. administration:
indicatively 20-40 mg/kg/day depending on gestational age, with some differences among various guidelines) and clinical uses
(more commonly as analgesic/antipyretic by oral or rectal route, but also i.v. in anaesthesia for postoperative analgesia and painful procedures
in Neonatal Intensive Care Units). Moreover, drug tolerability is discussed in the light of its potential hepatotoxicity and the unique
characteristics of the newborn patient.
By analyzing the available literature and the dosing guidelines, a mismatch exists between the current clinical use of paracetamol and the
recommendations, suggesting a cautious approach particularly in extremely preterm neonates
Urinary PGE(2) concentrations measured by a new EIA method in infants with urinary tract infections or renal malformations
No full text
Influence of prenatal drug treatments on kidney function during fetal and neonatal life.
No full textParacetamol (Acetaminophen) Efficacy and Safety in the Newborn
No full textNeonates can perceive pain, therefore an adequate analgesic therapy is a major issue not only from an ethical perspective but also to improve short- and long-term outcome. Fever during the neonatal period requires hospitalization and needs a treatment with an antipyretic agent because of the high risk of severe complications. Paracetamol (acetaminophen), the most commonly prescribed drug in paediatric patients for its analgesic and antipyretic effects, is the only agent recommended for use as an antipyretic in the newborn and has been recently proposed as a supplement therapy to opioids for postoperative analgesia. This article aims to give an updated overview on the use of paracetamol in newborns by presenting its pharmacological profile (mechanism of action, pharmacokinetics), recommendations for dosing regimens (oral or rectal administration: 25-30 mg/kg/day in preterm neonates of 30 weeks gestation, 45 mg/kg/day in preterm neonates of 34 weeks gestation, 60 mg/kg/day in term neonates; i.v. administration: indicatively 20-40 mg/kg/day depending on gestational age, with some differences among various guidelines) and clinical uses (more commonly as analgesic/antipyretic by oral or rectal route, but also i.v. in anaesthesia for postoperative analgesia and painful procedures in Neonatal Intensive Care Units). Moreover, drug tolerability is discussed in the light of its potential hepatotoxicity and the unique characteristics of the newborn patient. By analyzing the available literature and the dosing guidelines, a mismatch exists between the current clinical use of paracetamol and the recommendations, suggesting a cautious approach particularly in extremely preterm neonates
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