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The use of ciprofloxacin and fluconazole in Italian neonatal intensive care units: a nationwide survey

BACKGROUND: Treatment and prophylaxis of sepsis in very low birth weight neonates is a matter of concern and research is being undertaken with the aim to give rise to shared approaches based on solid evidence. As part of a European initiative, a survey was set up to describe the use of two drugs in...

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Autores principales: Pandolfini, Chiara, Marco, Sequi, Paolo, Manzoni, Maurizio, Bonati
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3546886/
https://www.ncbi.nlm.nih.gov/pubmed/23294560
http://dx.doi.org/10.1186/1471-2431-13-5
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author Pandolfini, Chiara
Marco, Sequi
Paolo, Manzoni
Maurizio, Bonati
author_facet Pandolfini, Chiara
Marco, Sequi
Paolo, Manzoni
Maurizio, Bonati
author_sort Pandolfini, Chiara
collection PubMed
description BACKGROUND: Treatment and prophylaxis of sepsis in very low birth weight neonates is a matter of concern and research is being undertaken with the aim to give rise to shared approaches based on solid evidence. As part of a European initiative, a survey was set up to describe the use of two drugs in this area. The Italian national practices concerning neonatal sepsis, as well as calls for related guidance, are described. METHODS: A standardized and previously tested questionnaire was submitted online to all Italian level III NICUs. A 5-point Likert scale was used to analyze attitudinal replies. Categorical variables were compared by χ2 analysis and 2-tailed P-values are reported. RESULTS: Data was provided by 38 Italian NICUs (36% of the country’s level III centers), 53% of which have 1–10 cases of bacterial sepsis monthly and 90% a prevalence of <1% fungal infections. Ciprofloxacin and fluconazole treatment for neonatal sepsis are scantly used in Italian NICUs (13% and 45%, respectively). Major concerns are related to the safety of ciprofloxacin and the efficacy of fluconazole. On the contrary, prophylaxis of fungal infections is a routine approach in many Italian NICUs. The use of both ciprofloxacin and fluconazole is characterized by a large inter-NICU variability in dose and scheme of use. The lack of adequate, shared evidence is a common consideration made by the survey participants. CONCLUSIONS: Common approaches are needed to standardize and update a national drug strategy for the prevention and treatment of sepsis in very low birth weight newborns. This can be achieved through collaborative initiatives aimed at setting up guidelines, based on available data, and multicenter trials to produce new evidence that will address the knowledge gaps.
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spelling pubmed-35468862013-01-17 The use of ciprofloxacin and fluconazole in Italian neonatal intensive care units: a nationwide survey Pandolfini, Chiara Marco, Sequi Paolo, Manzoni Maurizio, Bonati BMC Pediatr Research Article BACKGROUND: Treatment and prophylaxis of sepsis in very low birth weight neonates is a matter of concern and research is being undertaken with the aim to give rise to shared approaches based on solid evidence. As part of a European initiative, a survey was set up to describe the use of two drugs in this area. The Italian national practices concerning neonatal sepsis, as well as calls for related guidance, are described. METHODS: A standardized and previously tested questionnaire was submitted online to all Italian level III NICUs. A 5-point Likert scale was used to analyze attitudinal replies. Categorical variables were compared by χ2 analysis and 2-tailed P-values are reported. RESULTS: Data was provided by 38 Italian NICUs (36% of the country’s level III centers), 53% of which have 1–10 cases of bacterial sepsis monthly and 90% a prevalence of <1% fungal infections. Ciprofloxacin and fluconazole treatment for neonatal sepsis are scantly used in Italian NICUs (13% and 45%, respectively). Major concerns are related to the safety of ciprofloxacin and the efficacy of fluconazole. On the contrary, prophylaxis of fungal infections is a routine approach in many Italian NICUs. The use of both ciprofloxacin and fluconazole is characterized by a large inter-NICU variability in dose and scheme of use. The lack of adequate, shared evidence is a common consideration made by the survey participants. CONCLUSIONS: Common approaches are needed to standardize and update a national drug strategy for the prevention and treatment of sepsis in very low birth weight newborns. This can be achieved through collaborative initiatives aimed at setting up guidelines, based on available data, and multicenter trials to produce new evidence that will address the knowledge gaps. BioMed Central 2013-01-07 /pmc/articles/PMC3546886/ /pubmed/23294560 http://dx.doi.org/10.1186/1471-2431-13-5 Text en Copyright ©2013 Pandolfini et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Pandolfini, Chiara
Marco, Sequi
Paolo, Manzoni
Maurizio, Bonati
The use of ciprofloxacin and fluconazole in Italian neonatal intensive care units: a nationwide survey
title The use of ciprofloxacin and fluconazole in Italian neonatal intensive care units: a nationwide survey
title_full The use of ciprofloxacin and fluconazole in Italian neonatal intensive care units: a nationwide survey
title_fullStr The use of ciprofloxacin and fluconazole in Italian neonatal intensive care units: a nationwide survey
title_full_unstemmed The use of ciprofloxacin and fluconazole in Italian neonatal intensive care units: a nationwide survey
title_short The use of ciprofloxacin and fluconazole in Italian neonatal intensive care units: a nationwide survey
title_sort use of ciprofloxacin and fluconazole in italian neonatal intensive care units: a nationwide survey
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3546886/
https://www.ncbi.nlm.nih.gov/pubmed/23294560
http://dx.doi.org/10.1186/1471-2431-13-5
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