Ceftazidime (cf) versus netilmicin (nm) in the treatment of neonatal sepsis

The combination of an aminoglycoside and ampicillin is a commonly used regimen for the initial treatment of neonatal sepsis. Ceftazidime is one of the new cephalosporins, which may have certain advantages for the treatment of neonatal infections. We evaluated the efficacy and safety of CF plus flucloxacillin (FL) versus NM plus FL in a randomised comparative study. The addition of FL was decided because of the increased incidence of staphylococcal colonization/infections among the neonates admitted to our NICU the population of which consists only of outborn referrals. Nineteen neonates (10 preterm, 9 term) with clinical signs of infection entered the study protocol. Ten neonates received CF+FL and 9 NM+FL. All neonates had abnormal WCC and/or increased CRP value and 8 had positive blood cultures (5 Staph. aureus, 3 E.Coli). Seventeen neonates were cured and 2 died (both of the NM+FL group) probably of their underlying disease. No side effects or toxicity attributable to the antibiotic administration were observed. From the results of this small series it appears that the combination of CF+FL is effective in treating neonatal sepsis and probably preferable if aminoglycoside blood levels cannot be monitored.