Wide intra- and inter-country variability in drug use and dosage in very-low-birth-weight newborns with severe infections

Purpose: To describe the use of ciprofloxacin and fluconazole for the treatment of sepsis in European neonatal intensive care units (NICUs) in order to better orient research aimed at acquiring essential knowledge in this critical area. Methods: The survey consisted of an online questionnaire for...

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Main Authors: Pandolfini, Chiara, Kaguelidou, Florentia, Sequi, Marco, Jacqz-Aigrain, Evelyne, Choonara, Imti, Turner, Mark A., Manzoni, Paolo, Bonita, Maurizio
Format: Article
Published: Springer 2013
Online Access:https://eprints.nottingham.ac.uk/3130/
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author Pandolfini, Chiara
Kaguelidou, Florentia
Sequi, Marco
Jacqz-Aigrain, Evelyne
Choonara, Imti
Turner, Mark A.
Manzoni, Paolo
Bonita, Maurizio
author_facet Pandolfini, Chiara
Kaguelidou, Florentia
Sequi, Marco
Jacqz-Aigrain, Evelyne
Choonara, Imti
Turner, Mark A.
Manzoni, Paolo
Bonita, Maurizio
author_sort Pandolfini, Chiara
building Nottingham Research Data Repository
collection Online Access
description Purpose: To describe the use of ciprofloxacin and fluconazole for the treatment of sepsis in European neonatal intensive care units (NICUs) in order to better orient research aimed at acquiring essential knowledge in this critical area. Methods: The survey consisted of an online questionnaire for all participating NICUs on treatment schemes employed, rationales behind drug choices and interest in participation in research involving the two drugs. Results: A total of 189 level II and III NICUs participated in the survey, representing 25 countries, with Italy, UK and France providing the greatest number of centres (54% of total). Ciprofloxacin is used in 25% of NICUs that responded, although the indications for administering it vary between centres and the dosage ranges vary considerably, with 25% of NICUs giving ≤10 mg/kg/day and another 25 % giving ≥21 mg/kg/day. Factors given as affecting the decision to use ciprofloxacin are uncertainty about its safety and pharmacokinetics and level of penetration in the cerebrospinal fluid. Among the 70% of responding units that use fluconazole to treat fungal infection, 45% administer 6 mg/kg unit doses while 33% administer 12 mg/kg; 41% of NICUs use a 24-h interval between administrations while 20% wait 72h. Among the responding NICUs, 57% were willing to participate in a project on ciprofloxacin and 59% would consider participating in a randomized controlled trial evaluating fluconazole versus micafungin. Conclusions: Great variability in therapies exists within and between countries. Numerous centres are interested in participating in research on these drugs, highlighting the need for further knowledge on sepsis treatment and European centres’ interest in off-patent medicine research.
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spelling nottingham-31302020-05-04T20:19:27Z https://eprints.nottingham.ac.uk/3130/ Wide intra- and inter-country variability in drug use and dosage in very-low-birth-weight newborns with severe infections Pandolfini, Chiara Kaguelidou, Florentia Sequi, Marco Jacqz-Aigrain, Evelyne Choonara, Imti Turner, Mark A. Manzoni, Paolo Bonita, Maurizio Purpose: To describe the use of ciprofloxacin and fluconazole for the treatment of sepsis in European neonatal intensive care units (NICUs) in order to better orient research aimed at acquiring essential knowledge in this critical area. Methods: The survey consisted of an online questionnaire for all participating NICUs on treatment schemes employed, rationales behind drug choices and interest in participation in research involving the two drugs. Results: A total of 189 level II and III NICUs participated in the survey, representing 25 countries, with Italy, UK and France providing the greatest number of centres (54% of total). Ciprofloxacin is used in 25% of NICUs that responded, although the indications for administering it vary between centres and the dosage ranges vary considerably, with 25% of NICUs giving ≤10 mg/kg/day and another 25 % giving ≥21 mg/kg/day. Factors given as affecting the decision to use ciprofloxacin are uncertainty about its safety and pharmacokinetics and level of penetration in the cerebrospinal fluid. Among the 70% of responding units that use fluconazole to treat fungal infection, 45% administer 6 mg/kg unit doses while 33% administer 12 mg/kg; 41% of NICUs use a 24-h interval between administrations while 20% wait 72h. Among the responding NICUs, 57% were willing to participate in a project on ciprofloxacin and 59% would consider participating in a randomized controlled trial evaluating fluconazole versus micafungin. Conclusions: Great variability in therapies exists within and between countries. Numerous centres are interested in participating in research on these drugs, highlighting the need for further knowledge on sepsis treatment and European centres’ interest in off-patent medicine research. Springer 2013-04 Article PeerReviewed Pandolfini, Chiara, Kaguelidou, Florentia, Sequi, Marco, Jacqz-Aigrain, Evelyne, Choonara, Imti, Turner, Mark A., Manzoni, Paolo and Bonita, Maurizio (2013) Wide intra- and inter-country variability in drug use and dosage in very-low-birth-weight newborns with severe infections. European Journal of Clinical Pharmacology, 69 (4). pp. 1031-1036. ISSN 1432-1041 http://link.springer.com/article/10.1007%2Fs00228-012-1415-2 doi:10.1007/s00228-012-1415-2 doi:10.1007/s00228-012-1415-2
spellingShingle Pandolfini, Chiara
Kaguelidou, Florentia
Sequi, Marco
Jacqz-Aigrain, Evelyne
Choonara, Imti
Turner, Mark A.
Manzoni, Paolo
Bonita, Maurizio
Wide intra- and inter-country variability in drug use and dosage in very-low-birth-weight newborns with severe infections
title Wide intra- and inter-country variability in drug use and dosage in very-low-birth-weight newborns with severe infections
title_full Wide intra- and inter-country variability in drug use and dosage in very-low-birth-weight newborns with severe infections
title_fullStr Wide intra- and inter-country variability in drug use and dosage in very-low-birth-weight newborns with severe infections
title_full_unstemmed Wide intra- and inter-country variability in drug use and dosage in very-low-birth-weight newborns with severe infections
title_short Wide intra- and inter-country variability in drug use and dosage in very-low-birth-weight newborns with severe infections
title_sort wide intra- and inter-country variability in drug use and dosage in very-low-birth-weight newborns with severe infections
url https://eprints.nottingham.ac.uk/3130/
https://eprints.nottingham.ac.uk/3130/
https://eprints.nottingham.ac.uk/3130/