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Therapeutic guidelines for prescribing antibiotics in neonates should be evidence-based: a French national survey

Abstract : OBJECTIVE: This survey aims to describe and analyse the dosage regimens of antibiotics in French neonatal intensive care units (NICUs). METHODS: Senior doctors from 56 French NICUs were contacted by telephone and/or email to provide their local guidelines for antibiotic therapy. RESULTS: 44 (79%) NICUs agreed to participate in this survey. In total, 444 dosage regimens were identified in French NICUs for 41 antibiotics. The number of different dosage regimens varied from 1 to 32 per drug (mean 9, SD 7.8). 37% of intravenous dosage regimens used a unique mg/kg dose from preterm to full-term neonates. Doses and/or dosing intervals varied significantly for 12 antibiotics (amikacin, gentamicin, netilmicin, tobramycin, vancomycin administered as continuous infusion, ceftazidime, cloxacillin, oxacillin, penicillin G, imipenem/cilastatin, clindamycin and metronidazole). Among these antibiotics, 6 were used in more than 70% of local guidelines and had significant variations in (1) maintenance daily doses for amikacin, imipenem/cilastatin, ceftazidime and metronidazole; (2) loading doses for continuous infusion of vancomycin; and (3) dosing intervals for gentamicin and amikacin. CONCLUSIONS: A considerable inter-centre variability of dosage regimens of antibiotics exists in French NICUs. Developmental pharmacokinetic-pharmacodynamic studies are essential for the evaluation of antibiotics in order to establish evidence-based dosage regimens for effective and safe administration in neonates.
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Contributor : Laurent Jonchère Connect in order to contact the contributor
Submitted on : Wednesday, April 29, 2015 - 3:02:09 PM
Last modification on : Thursday, January 14, 2021 - 11:25:04 AM

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Stéphanie Leroux, Wei Zhao, Pierre Bétrémieux, Patrick Pladys, Elie Saliba, et al.. Therapeutic guidelines for prescribing antibiotics in neonates should be evidence-based: a French national survey. Archives of Disease in Childhood, BMJ Publishing Group, 2015, 100 (4), pp.394--398. ⟨10.1136/archdischild-2014-306873⟩. ⟨hal-01147039⟩



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