1561 MEZLOCILLIN (MEZ) VS. CONVENTIONAL BINATION ANTI-MICROBIAL THERAPY FOR PREMATURE INFANTS ADMITTED TO AN INTENSIVE CARE NURSERY (ICN)

Abstract

The combination of ampicillin with an aminoglycoside is the conventional antimicrobial therapy for premature infants admitted to an ICN. If MEZ alone is at least as effective as the combined use of ampicillin and amikacin (AMI), it should be preferentially used because it is cheaper and less toxic. Criteria for proven or suspect infections, and for the clinical response to therapy were used to evaluate each infant's response to the selected therapy. This evaluation was done without the knowledge of which antibiotic was used. One-half of 172 premature infants studied were randomly selected to be treated with MEZ. The efficacy of therapy for proven or suspect infections as well as the incidences of apnea, hypotension, and nephrotoxicity in this group were compared to the other group of 86 patients who received the conventional combination therapy. There were no differences between the two patient groups in their birth weights (1.39 kilo vs. 1.42 kilo), gestational ages (30 wks vs. 31 wks), nor in the incidences of apnea or hypotension. The clinical response in patients with suspect (42 patients) or proven (30 patients) infections were no different between the two therapies. AMI therapy was more nephrotoxic as demonstrated by a diminished postnatal rise in creatinine clearance in the patients receiving this drug. (42% vs. 23% rise in creatinine clearance) These data support the use of MEZ in premature infants with the diagnosis of infection.