Impact of empiric antibiotic regimen on bowel colonization in neonates with suspected early onset sepsis

Ü. Parm (1) , T. Metsvaht (2) , E. Sepp (1) , M.-L. Ilmoja (3) , H. Pisarev (4) , M. Pauskar (1) , I. Lutsar (1)

1 Institute of Microbiology
2 Clinics of Anaesthesiology and Intensive Care
3 Paediatric Intensive Care
4 Department of Public Health

The purpose of this study was to compare the impact of ampicillin and penicillin used for empiric treatment of early onset sepsis (EOS) on initial gut colonization by aerobic and facultative anaerobic microorganisms. A cluster-randomized, two-center, switch-over study was conducted in two paediatric intensive care units in Estonia and included 276 neonates. Rectal swabs were collected twice a week until discharge or day 60. Colonizing microbes were identified on species level and tested for ampicillin resistance (AR). The number of patients colonized with Gram negative microorganisms and spp was similar in both treatment arms but ampicillin resulted in longer colonization duration (CD) of ( = 0.012), AR spp ( = 0.012) and spp ( = 0.02) and penicillin in that of AR spp ( = 0.001). As for Gram positive microorganisms penicillin treatment was associated with a greater number of colonized patients and higher CD of spp and but lower ones of and . Influence of ampicillin and penicillin on initial gut colonization is somewhat different but these differences are of low clinical relevance and should not be a limiting step when choosing between these two antibiotics for the empiric treatment of EOS.

Mots clés: Life Sciences

Ü. Parm, T. Metsvaht, E. Sepp, M.-L. Ilmoja, H. Pisarev, et al.. Impact of empiric antibiotic regimen on bowel colonization in neonates with suspected early onset sepsis. European Journal of Clinical Microbiology and Infectious Diseases, 2010, 29 (7), pp.807-816. ⟨10.1007/s10096-010-0931-1⟩. ⟨hal-00590997⟩