Published online May 1, 2006
PEDIATRICS Vol. 117 No. 5 May 2006, pp. 1857 (doi:10.1542/peds.2006-0067)
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Ampicillin and Cefotaxime as a Risk Factor of Neonatal Death

Ping-Ing Lee, MD, PhD
Department of Pediatrics
National Taiwan University Hospital
Taipei 10002, Taiwan

To the Editor.

By a retrospective review of 128914 records of inborn neonates, Clark et al1 concluded that for neonates receiving ampicillin, the concurrent use of cefotaxime during the first 3 days of life is an independent risk factor of neonatal death. The authors pointed out the limitations of such a retrospective review. In addition, for both univariate and multivariate analyses, patients with either sepsis or meningitis were put into a single category, which may create an important confounding factor. Table 2 of their article showed that patients having received cefotaxime therapy were more likely to have some severe complications, including liver dysfunction, renal failure, cardiac arrest, etc. These important confounding variables were not included in the multivariate analysis. If the study results are to be convincing, these confounding variables should be added to the model.

REFERENCE

  1. Clark RH, Bloom BT, Spitzer AR, Gerstmann DR. 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. Pediatrics. 2006;117 :67 –74[Abstract/Free Full Text]
PEDIATRICS (ISSN 1098-4275). ©2006 by the American Academy of Pediatrics

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Ampicillin and Cefotaxime as a Risk Factor of Neonatal Death: In Reply
Reese H. Clark, Barry T. Bloom, Dale R. Gerstmann, and Alan R. Spitzer
Pediatrics 2006 117: 1857-1858. [Extract] [Full Text]  




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