Feasibility and efficacy of gentamicin for treating neonatal sepsis in community-based settings: a systematic review
Background Neonatal sepsis is a leading cause of neonatal deaths in developing countries. The current recommended in-hospital treatment is parenteral ampicillin (or penicillin) and gentamicin in young infants for 10- 14 days; however, very few could access and afford. The current review is to evaluate the feasibility of gentamicin in community based settings. Methods Both observational and randomized controlled trials were included. Medline, Embase, Cochrane Central Register of Controlled Trials and Central Trial Register of India were searched until September 2013. We assessed the risk of bias by Cochrane Collaboration’s "risk of bias" tool. Results Two observational studies indicated feasibility ensuring coverage of population, decrease in case fatality rate in the group treated by community health workers. In an RCT, no significant difference was observed in the treatment failure rates [odds ratio (OR)=0.88], and the mortality in the first and second week (OR=1.53; OR=2.24) between gentamicin and ceftriaxone groups. Within the gentamicin group, the combination of penicillin and gentamicin showed a lower rate of treatment failure (OR=0.44) and mortality at second week of life (OR=0.17) as compared to the combination of gentamicin and oral cotrimoxazole. Conclusion Gentamicin for the treatment of neonatal sepsis is both feasible and effective in community-based settings and can be used as an alternative to the hospitalbased care in resource compromised settings. But there was less evidence in the management of neonatal sepsis in hospitals as was seen in this review in which we included only one RCT and three observational studies..
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2016 |
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| Erschienen: |
2016 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:12 |
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| Enthalten in: |
World journal of pediatrics - 12(2016), 4 vom: 01. Feb., Seite 408-414 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Jaiswal, Nishant [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Anmerkungen: |
© Children's Hospital, Zhejiang University School of Medicine and Springer-Verlag Berlin Heidelberg 2016 |
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| doi: |
10.1007/s12519-016-0005-2 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
OLC202825131X |
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| 245 | 1 | 0 | |a Feasibility and efficacy of gentamicin for treating neonatal sepsis in community-based settings: a systematic review |
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| 500 | |a © Children's Hospital, Zhejiang University School of Medicine and Springer-Verlag Berlin Heidelberg 2016 | ||
| 520 | |a Background Neonatal sepsis is a leading cause of neonatal deaths in developing countries. The current recommended in-hospital treatment is parenteral ampicillin (or penicillin) and gentamicin in young infants for 10- 14 days; however, very few could access and afford. The current review is to evaluate the feasibility of gentamicin in community based settings. Methods Both observational and randomized controlled trials were included. Medline, Embase, Cochrane Central Register of Controlled Trials and Central Trial Register of India were searched until September 2013. We assessed the risk of bias by Cochrane Collaboration’s "risk of bias" tool. Results Two observational studies indicated feasibility ensuring coverage of population, decrease in case fatality rate in the group treated by community health workers. In an RCT, no significant difference was observed in the treatment failure rates [odds ratio (OR)=0.88], and the mortality in the first and second week (OR=1.53; OR=2.24) between gentamicin and ceftriaxone groups. Within the gentamicin group, the combination of penicillin and gentamicin showed a lower rate of treatment failure (OR=0.44) and mortality at second week of life (OR=0.17) as compared to the combination of gentamicin and oral cotrimoxazole. Conclusion Gentamicin for the treatment of neonatal sepsis is both feasible and effective in community-based settings and can be used as an alternative to the hospitalbased care in resource compromised settings. But there was less evidence in the management of neonatal sepsis in hospitals as was seen in this review in which we included only one RCT and three observational studies. | ||
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| 700 | 1 | |a Singh, Meenu |4 aut | |
| 700 | 1 | |a Kondel, Ritika |4 aut | |
| 700 | 1 | |a Kaur, Navjot |4 aut | |
| 700 | 1 | |a Thumburu, Kiran K. |4 aut | |
| 700 | 1 | |a Kumar, Ajay |4 aut | |
| 700 | 1 | |a Kaur, Harpreet |4 aut | |
| 700 | 1 | |a Chadha, Neelima |4 aut | |
| 700 | 1 | |a Gupta, Neeraj |4 aut | |
| 700 | 1 | |a Agarwal, Amit |4 aut | |
| 700 | 1 | |a Malhotra, Samir |4 aut | |
| 700 | 1 | |a Shafiq, Nusrat |4 aut | |
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