{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T02:19:28Z","timestamp":1788833968823,"version":"build-2803163510"},"reference-count":14,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2006,1,1]]},"abstract":"<jats:p>BACKGROUND. We reported previously that the use of cephalosporin among premature neonates increased the risk of subsequent fungal sepsis. As a result, we recommended that ampicillin and gentamicin be used as empiric coverage for early-onset neonatal sepsis while culture results are awaited.<\/jats:p>\n               <jats:p>OBJECTIVES. To describe antibiotic use during the first 3 days after birth for neonates admitted to the NICU and to evaluate the outcomes for neonates treated with 2 different antibiotic regimens.<\/jats:p>\n               <jats:p>METHODS. We assembled a cohort of inborn neonates, from our deidentified administrative database, who had documented exposure to ampicillin during the first 3 days after birth. Infants treated concurrently with cefotaxime or gentamicin were evaluated, to identify the factors that were associated independently with death before discharge, with both univariate and multivariate analyses.<\/jats:p>\n               <jats:p>RESULTS. There were 128914 neonates selected as the study cohort; 24111 were treated concurrently with ampicillin and cefotaxime and 104803 were treated concurrently with ampicillin and gentamicin. Logistic modeling showed that neonates treated with ampicillin\/cefotaxime were more likely to die (adjusted odds ratio: 1.5; 95% confidence interval: 1.4\u20131.7) and were less likely to be discharged to home or foster care than were neonates treated with ampicillin\/gentamicin. This observation was true across all estimated gestational ages. Other factors that were associated independently with death included immature gestational age, need for assisted ventilation on the day of admission to the NICU, indications of perinatal asphyxia or major congenital anomaly, and reported use of ampicillin\/cefotaxime.<\/jats:p>\n               <jats:p>CONCLUSIONS. For patients receiving ampicillin, the concurrent use of cefotaxime during the first 3 days after birth either is a surrogate for an unrecognized factor or is itself associated with an increased risk of death, compared with the concurrent use of gentamicin.<\/jats:p>","DOI":"10.1542\/peds.2005-0179","type":"journal-article","created":{"date-parts":[[2006,1,5]],"date-time":"2006-01-05T02:28:34Z","timestamp":1136428114000},"page":"67-74","source":"Crossref","is-referenced-by-count":207,"title":["Empiric Use of Ampicillin and Cefotaxime, Compared With Ampicillin and Gentamicin, for Neonates at Risk for Sepsis Is Associated With an Increased Risk of Neonatal Death"],"prefix":"10.1542","volume":"117","author":[{"given":"Reese H.","family":"Clark","sequence":"first","affiliation":[{"name":"Pediatrix-Obstetrix Center for Research and Education, Sunrise, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry T.","family":"Bloom","sequence":"additional","affiliation":[{"name":"Pediatrix-Obstetrix Center for Research and Education, Sunrise, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan R.","family":"Spitzer","sequence":"additional","affiliation":[{"name":"Pediatrix-Obstetrix Center for Research and Education, Sunrise, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dale R.","family":"Gerstmann","sequence":"additional","affiliation":[{"name":"Pediatrix-Obstetrix Center for Research and Education, Sunrise, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2006,1,1]]},"reference":[{"key":"2021120819445474800_R1","doi-asserted-by":"crossref","unstructured":"Alarcon A, Pena P, Salas S, Sancha M, Omenaca F. Neonatal early onset Escherichia coli sepsis: trends in incidence and antimicrobial resistance in the era of intrapartum antimicrobial prophylaxis. Pediatr Infect Dis J.\u20082004;23:295\u2013299","DOI":"10.1097\/00006454-200404000-00004"},{"key":"2021120819445474800_R2","doi-asserted-by":"crossref","unstructured":"Luck S, Torny M, d\u2019Agapeyeff K, et al. Estimated early-onset group B streptococcal neonatal disease. Lancet.\u20082003;361:1953\u20131954","DOI":"10.1016\/S0140-6736(03)13553-2"},{"key":"2021120819445474800_R3","doi-asserted-by":"crossref","unstructured":"American College of Obstetricians and Gynecologists. ACOG Committee Opinion: number 279, December 2002: prevention of early-onset group B streptococcal disease in newborns. Obstet Gynecol.\u20082002;100:1405\u20131412","DOI":"10.1097\/00006250-200212000-00044"},{"key":"2021120819445474800_R4","doi-asserted-by":"crossref","unstructured":"Stoll BJ, Hansen N, Fanaroff AA, et al. Changes in pathogens causing early-onset sepsis in very-low-birth-weight infants. N Engl J Med.\u20082002;347:240\u2013247","DOI":"10.1056\/NEJMoa012657"},{"key":"2021120819445474800_R5","doi-asserted-by":"crossref","unstructured":"American Academy of Pediatrics, Committee on Infectious Diseases and Committee on Fetus and Newborn. Revised guidelines for prevention of early-onset group B streptococcal (GBS) infection. Pediatrics.\u20081997;99:489\u2013496","DOI":"10.1542\/peds.99.3.489"},{"key":"2021120819445474800_R6","unstructured":"Baker CJ, Kanto WP Jr. Implementing new GBS guidelines requires coordinated care. AAP News.\u20082003;22(2):79\u201386"},{"key":"2021120819445474800_R7","doi-asserted-by":"crossref","unstructured":"de Man P, Verhoeven BA, Verbrugh HA, Vos MC, van den Anker JN. An antibiotic policy to prevent emergence of resistant bacilli. Lancet.\u20082000;355:973\u2013978","DOI":"10.1016\/S0140-6736(00)90015-1"},{"key":"2021120819445474800_R8","doi-asserted-by":"crossref","unstructured":"Cordero L, Rau R, Taylor D, Ayers LW. Enteric Gram-negative bacilli bloodstream infections: 17 years\u2019 experience in a neonatal intensive care unit. Am J Infect Control.\u20082004;32:189\u2013195","DOI":"10.1016\/j.ajic.2003.07.004"},{"key":"2021120819445474800_R9","doi-asserted-by":"crossref","unstructured":"Benjamin DK Jr, DeLong ER, Steinbach WJ, Cotton CM, Walsh TJ, Clark RH. Empirical therapy for neonatal candidemia in very low birth weight infants. Pediatrics.\u20082003;112:543\u2013547","DOI":"10.1542\/peds.112.3.543"},{"key":"2021120819445474800_R10","doi-asserted-by":"crossref","unstructured":"Clark R, Powers R, White R, Bloom B, Sanchez P, Benjamin DK Jr. Prevention and treatment of nosocomial sepsis in the NICU. J Perinatol.\u20082004;24:446\u2013453","DOI":"10.1038\/sj.jp.7211125"},{"key":"2021120819445474800_R11","doi-asserted-by":"crossref","unstructured":"Benjamin DK, DeLong E, Cotten CM, Garges HP, Steinbach WJ, Clark RH. Mortality following blood culture in premature infants: increased with Gram-negative bacteremia and candidemia, but not Gram-positive bacteremia. J Perinatol.\u20082004;24:175\u2013180","DOI":"10.1038\/sj.jp.7211068"},{"key":"2021120819445474800_R12","doi-asserted-by":"crossref","unstructured":"Benjamin DK Jr, DeLong ER, Cotten CM, Garges HP, Clark RH. Postconception age and other risk factors associated with mortality following Gram-negative rod bacteremia. J Perinatol.\u20082004;24:169\u2013174","DOI":"10.1038\/sj.jp.7211047"},{"key":"2021120819445474800_R13","doi-asserted-by":"crossref","unstructured":"Garite TJ, Clark R, Thorp JA. Intrauterine growth restriction increases morbidity and mortality among premature neonates. 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