Prophylactic systemic antifungal agents to prevent mortality and morbidity in very low birth weight infants

Clemin­son, et al, Sept 2015 The Cochrane Library Abstract Back­ground Inva­sive fun­gal infec­tion is an impor­tant cause of mor­tal­i­ty and mor­bid­i­ty in very preterm and very low birth weight infants. Ear­ly diag­no­sis is dif­fi­cult and treat­ment is often delayed. Sys­tem­i­cal­ly absorbed anti­fun­gal agents (usu­al­ly azoles) are increas­ing­ly used as pro­phy­lax­is…

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Effect of fluconazole prophylaxis on candidiasis and mortality in premature infants: a randomized clinical trial.

Ben­jamin et al, JAMA. 2014 May Abstract IMPORTANCE: Inva­sive can­didi­a­sis in pre­ma­ture infants caus­es death and neu­rode­vel­op­men­tal impair­ment. Flu­cona­zole pro­phy­lax­is reduces can­didi­a­sis, but its effect on mor­tal­i­ty and the safe­ty of flu­cona­zole are unknown. OBJECTIVE: To eval­u­ate the effi­ca­cy and safe­ty of flu­cona­zole in pre­vent­ing death or inva­sive can­didi­a­sis in extreme­ly low-birth-weight infants. Among infants with a…

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Pharmacokinetics and pharmacodynamics of antibacterials, antifungals, and antivirals used most frequently in neonates and infants.

Roberts ‚et al, Clin Phar­ma­cokinet. 2014 Jul Abstract Antimi­cro­bials and antivi­rals are wide­ly used in young infants and neonates. β-Lac­­tam antibac­te­r­i­al activ­i­ty is max­i­mized when the plas­ma con­cen­tra­tion exceeds the min­i­mum inhibito­ry con­cen­tra­tion for a pro­longed peri­od, sug­gest­ing that more fre­quent dos­ing may opti­mize β-lac­­tam ther­a­py. Amino­gly­co­sides are typ­i­cal­ly admin­is­tered at longer…

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Clinical pharmacology of furosemide in neonates: a review.

Paci­fi­ci, Phar­ma­ceu­ti­cals (Basel), 2013 Abstract Furosemide is the diuret­ic most used in new­born infants. It blocks the Na+-K+-2Cl- sym­porter in the thick ascend­ing limb of the loop of Hen­le increas­ing uri­nary excre­tion of Na+ and Cl-. This arti­cle aimed to review the pub­lished data on the clin­i­cal phar­ma­col­o­gy of furosemide in neonates…

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Pharmacological Therapy of Gastroesophageal Reflux in Preterm Infants

Cor­vaglia et al, Gas­troen­terol­o­gy Research and Prac­tice, Vol­ume 2013 (2013) Abstract Although gas­troe­sophageal reflux (GER) is a very com­mon phe­nom­e­non among preterm infants, its ther­a­peu­tic man­age­ment is still an issue of debate among neona­tol­o­gists. A step-wise approach should be advis­able, first­ly pro­mot­ing non­phar­ma­co­log­i­cal inter­ven­tions and lim­it­ing drugs to select­ed infants unre­spon­sive to the con­ser­v­a­tive…

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Ranitidine is associated with infections, necrotizing enterocolitis, and fatal outcome in newborns

Ter­rin et al, Pedi­atrics, 2012 Gas­tric acid­i­ty is a major non­im­mune defense mech­a­nism against infec­tions. The objec­tive of this study was to inves­ti­gate whether ran­i­ti­dine treat­ment in very low birth weight (VLBW) infants is asso­ci­at­ed with an increased risk of infec­tions, necro­tiz­ing ente­ro­col­i­tis (NEC), and fatal out­come. RESULTS: We eval­u­at­ed 274 VLBW

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Postnatal phenobarbital for the prevention of intraventricular haemorrhage in preterm infants

Smit et al, 2013, Cochrane neona­tol­ogy group Intra­ven­tric­u­lar haem­or­rhage (IVH) is a major com­pli­ca­tion of preterm birth. Large haem­or­rhages are asso­ci­at­ed with a high risk of dis­abil­i­ty and hydro­cephalus. Insta­bil­i­ty of blood pres­sure and cere­bral blood flow are pos­tu­lat­ed as causative fac­tors. Anoth­er mech­a­nism may involve reper­fu­sion dam­age from oxy­gen…

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A propensity-matched cohort study of vancomycin-associated nephrotoxicity in neonates

Con­stance et al, Arch Dis Child Fetal Neona­tal Ed. 2015 Sep 23.  BACKGROUND: The inci­dence of nephro­tox­i­c­i­ty among van­­comycin-treat­ed neonates has been report­ed to range from 2% to 20%. These wide­ly vary­ing esti­mates have led to con­fu­sion and con­tro­ver­sy regard­ing the safe­ty of van­comycin among neonates. OBJECTIVE: Eval­u­ate the inci­dence of nephro­tox­i­c­i­ty among neonates receiv­ing van­comycin con­comi­tant­ly…

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Long-term effects of caffeine therapy for apnea of prematurity on sleep at school age

Am J Respir Crit Care Med.  2014; Mar­cus et al RATIONALE: Apnea of pre­ma­tu­ri­ty is a com­mon con­di­tion that is usu­al­ly treat­ed with caf­feine, an adeno­sine recep­tor block­er that has pow­er­ful influ­ences on the cen­tral ner­vous sys­tem. How­ev­er, lit­tle is known about the long-term effects of caf­feine on sleep in the…

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