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Abstract
Sepsis is an acute life-threatening medical condition. Empiric antimicrobial therapy should be instituted as soon as cultures have been obtained, the principal goal of which is complete eradication of the pathogen as quickly as possible with the fewest adverse effects to the patient.
Antimicrobial resistance is an important determinant of mortality. β-lactam antimicrobials are widely recognized for their efficacy and low toxicity. The carbapenems are eminently suitable for broad-spectrum monotherapy
The carbapenem antibiotics offer therapeutic options for antibiotic-resistant organisms encountered in the neonatal intensive care unit .However, there are few published reports of carbapenem use in neonates.
The present study was therefore designed to evaluate the efficacy and tolerability of carbapenems as a monotherapy for infants with sepsis resistant to standard treatment approaches
The present study aimed at evaluating the therapeutic effects and tolerability of “carbapenems” [Meropenem] in neonates with sepsis resistant to standard lines of treatment.
This study is a ”prospective analytic” study conducted in the “NICU” of the university hospital well as other hospitals in Cairo. It involved “44” neonates who met the “inclusion criteria” :(< 28 days), with clinical signs and symptoms of sepsis & that have not responded to routine antibiotic within 5-7 days of starting the treatment [i.e.: without clinical, radiological or laboratory improvement].
”Meronem” (meropenem): was administered to the neonates who haven’t been responding to standard conventional treatment. The mean duration of antibiotic therapy was: 10 ± 1.2 days.
Clinical evaluation was done to all the neonates prior to and after the treatment. Also, laboratory and microbiological procedures were made before and after the administration of the antibiotic.
Those included: Body temperature, heart rate (HR), (respiratory rate) RR, activity, crying, feeding, abdominal distension, skin eruptions. Laboratory investigations included: Blood culture, & cultures from other focuses -if available-, CBC, Hemoglobin (Hb), CRP (C reactive protein), Liver enzymes and serum Creatinine
Radiological investigations (Chest X-ray, Abdominal X-ray, CT, US, etc.) were done –if indicated- as well.
The presence of adverse reactions was also investigated.
All of these parameters were done prior to and after completion of parenteral therapy with “Meropenem”.
Finally, “Evaluation of Response” was done and classified to be: Improvement, Partial Improvement or Failure (as evidenced by the clinical, microbiological, laboratory and radiological findings).