Combination therapy of β-lactam antibiotics has been used widely to treat severe infections in neonates. The widespread use of β-lactam antibiotics has resulted in emergence of a broad variety of plasmid or chromosome mediated β-lactamases.
Also,
there is a great propensity for these enzymes to spread among various species of bacteria. Thus, the use of β-lactamase inhibitor antibiotics may be of great interest and has potential therapeutic value in severe neonatal infections. We tried to
find
out the efficacy and safety of clavulante potentiated amoxycillin (Augmentin) in treatment of severe neonatal infections. Total thirty-five neonates with sepsis(26) or severe organ infections(9) were involved. Each 30mg/kg dose of Augmentin was
injected
at 12hr-or 8hr-or 6hr-intervals according to the age and weight of neonates. Clinically 77.1% of the cases were cured, and microbiologically 80.0% were eliminated. 88.9% of eighteen gram positive organisms(S. aureus, S. epidermidis, -hemolytic
strep.,
S. pneumoniae, E. faecalis) isolated from study group were susceptible to Augmentin. 47.0% of gram-negative organisms (K. pmeumoniae, E. coli, P. mirabilis, S. marcescens, C. freundii) were
suceptible. Thus, it was confirmed that Augmentin was very effective in ampicillin-or ceftriaxone-resistant gram positive cocci infections, but less effective in isolated K. pneumoniae and S.marcescens cases. The serum levels of amoxycillin in
the
neonates were maintined above 6 g/ml until 1hr. at each injection. We observed that alkaline phosphatase level was elevated above 1,000IU/e in three neonates and that skin rash developed after injection in one neonate. But, these side effects
were
mild
and transient. These results suggest that Augmentin may be tolerable and effective in treating severe gram positive cocci infections in neonates.
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