بررسي نتايج مصرف آنتي بيوتيك در سپتي سمي گرم منفي كودكان و نوزادان

Survey on Efficacy of Antibiotics in Gram Negative Septicemia in Neonates and Children

Introduction: Septicemia is a common and serious disease in pediatric group. The majority of children who are hospitalized and get septicemic, their infections are due to gram negative pathogens. Objective: This study aimed to examine the results of antibiotics consumption in gram negative septicemia among neonates and children and to choose the appropriate and effective antibiotics for treatment of gram negative septicemia in our community. Materials and Methods: Inpatients in Hefdah- Shahriver Children Hospital were examined for symptoms of gram negative septicemia for a one- year period, and a total of 50 cases with positive blood culture. Blood cultures obtained were tested in terms of bacterial growth and the type of bacteria was found on basis of colonization. Then antibiogram was taken and antibiotics sensitivities were determined by in vitro. Also, the effect of elective antibiotics for improvement was investigated in vivo. Results: In data analysis, it was found that the most common infective pathogen was E.coli (46%) and Klebsilla (27%) was in the second place. The majority of patients were in the age group of neonates (86%). After that, in ages above 5 years, prevalence rate of gram negative septicemia was greater (10%). In view point of risk factors of the disease, IV catheter (13%), prematurity in neonates (8%) and urinary infection in other ages were more common. In terms of antibiotics sensitivity, the highest susceptibility was seen in Amikacine and only few cases of resistance to it were observed so that E.coli and anterobacter susceptibility to Amikacine was 6% and that of Klebsilla and Psodomona was about 100% . Conclusion: Third generation of Cephalosporines were effective for these pathogens in 76% of cases. In spite of lower laboratory susceptibility to the third generation of antibiotics, treatments were often carried out by those antibiotics and good clinical responses were observed.