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Journal of Antimicrobial Chemotherapy (1987) 20, 421-429
© 1987 The British Society for Antimicrobial Chemotherapy

research-article

Comparison of two antibiotic regimens for neonatal necrotizing enterocolitis

David W. Scheifele, Gordean L. Ginter, Edna Olsen, Susan Fussell and Margaret Pendraya

Divisions of Infectious Diseases, The University of British Columbia, The Research Center Room 303, 950 West 28th Avenue, Vancouver, B.C., V5Z 4H4, Canada aNewborn Medicine, Department of Paediatrics, The University of British Columbia, The Research Center Room 303, 950 West 28th Avenue, Vancouver, B.C., V5Z 4H4, Canada

Received 10 March 1987;

Treatment of neonatal necrotizing enterocolitis (NEC) regularly includes broadspectrum antibiotics but there has been no comparative study of alternative regimens. We have studied 90 infants with definite NEC; 46 cases in 1982–3 were treated with ampicillin and gentamicin, while 44 cases in 1984–5 received cefotaxime and vancomycin. Groups were well matched and managed uniformly. Infants ≥2200 g birthweight did well with either regimen. Smaller infants given cefotaxime and vancomycin had a lower risk of culture-positive peritonitis (P=0.01), and as a result, were less likely to die (P=0.048) or develop thrombocytopenia (P = 0.004). The better outcome might be explained by the greater suppression by cefotaxime and vancomycin of the gut flora of treated patients (P < 0.001). Both regimens were well-tolerated. Our data suggest that carefully chosen antibiotic regimens can improve the outcome of NEC.


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