Are You Going Overboard on Cephalosporins?

Abstract

#### The study This prospective chart review study (2011–2013) from Texas included infants aged ≤60 days with a positive culture from the blood, urine, or cerebrospinal fluid. The researcher’s objectives were to study the pathogens and the optimal choice of antibiotics in infants with serious bacterial infection (SBI). #### The key findings The study found 265 infants with SBI. Of those infants, 11% had meningitis, 25% had bacteremia or bacteremia with urinary tract infection, and 64% had urinary tract infection alone. Escherichia coli and group B Streptococcus were the predominate pathogens. There were no cases of methicillin-resistant Staphylococcus aureus , vancomycin-resistant Enterococcus , or penicillin-resistant Streptococcus pneumonia. For infants aged ≤28 days, the combination of ampicillin and gentamicin was used in 78% of cases, whereas a third-generation cephalosporin was used in 22% of cases. For infants aged ≥29 days, ampicillin and gentamicin were used in 13% of cases, and a third-generation cephalosporin was used in 87% of cases. The authors noted that when meningitis was not suspected, regimens of either ampicillin/gentamicin or a third-generation cephalosporin were equally effective based on susceptibility data (96% and 97%). They also noted that 67% of cases in which a third-generation cephalosporin was used resulted in unnecessarily broad coverage compared with ampicillin/gentamicin. Also, …