CLINICAL-EXPERIENCE WITH CEFTRIAXONE TREATMENT IN THE NEONATE

The safety of ceftriaxone has been evaluated in 80 neonates who were t reated empirically for suspected infection with either ceftriaxone and ampicillin (group A, age 0-72 h) or ceftriaxone and vancomycin (group B, age greater than 72 h). Within 48 h after birth 2 group A patients died from sepsis (Haemophilus influenzae, Streptococcus pneumoniae, 1 case each); 1 group B patient died from sepsis (Pseudomonas aeruginos a). All bacterial isolates from group A patients were susceptible to c eftriaxone, but in 4 of the 8 group B patients with positive cultures a change in antibiotic therapy was required. Eosinophilia, thrombocyto sis and an increase in serum alkaline phosphatases were observed in a limited number of patients during and after discontinuation of treatme nt. Direct hyperbilirubinemia ( > 2 mg/dl) occurred in 2 cases during treatment. Gallbladder sludge was sonographically diagnosed in 6 patie nts, but disappeared within 2 weeks after detection. One neonate had e xanthema. Nurses rated ease of administration as very good. Ceftriaxon e appears to be an interesting alternative in the empiric antibiotic t reatment in the early neonatal period.