THERAPEUTIC CONSIDERATIONS FOR UREAPLASMA-UREALYTICUM INFECTIONS IN NEONATES

Appreciation of Ureaplasma urealyticum as a human pathogen and documen tation of antibiotic resistance have heightened interest in susceptibi lity testing and treatment alternatives. Treatment of neonates poses s pecial problems because of potential drug toxicity, clinical unfamilia rity with the various conditions that may be due to or associated with ureaplasmal infection, and frequent isolation of the organism from mu cosal surfaces in the absence of overt illness. Case reports have unde niably demonstrated the ability of U. urealyticum to cause neonatal ba cteremia, pneumonia, and meningitis, although the frequency with which such clinically significant infections occur among the greater popula tion of colonized neonates is unknown. The association of U. urealytic um with development of chronic lung disease of prematurity further int ensifies the need for knowledge concerning effective antimicrobial tre atment. Despite controversy stemming from nonstandardized susceptibili ty testing, erythromycin is the drug of choice for treating neonatal u reaplasmal infections not involving the central nervous system. The us e of erythromycin is supported by its activity in vitro, limited data from clinical experience, and preliminary pharmacokinetic and safety s tudies.