Impact of Empirical Antibiotic Treatment Duration on Short-term Prognosis of Very Low Birth Weight Newborns

Objective: Probable early infection is one of the most important reasons to begin antibiotics treatment for very low birth weight (VLBW) infants. In most of the cases, antibiotics treatment continues as long as the venous line persist. Long-term empirical antibiotics therapy for premature infants (5 days) create even more danger than the infection itself, such as necrotizing enterocolitis (NEC) and death. In order to reduce the risks of these dangers, antimicrobial therapy must stop in clinical conditions in which the possibility of infection is low. This study makes an effort to evaluate the impact of empirical antibiotic treatment duration on early prognosis of premature infants with VLBW. Materials and Methods: A total of 209 premature infants with birth weight less than 1500 g who were suspicious of having infection, were evaluated in 2 groups of control (107 infants) and intervention (102 infants). All of the infants evaluated for sepsis according to the protocol of the unit. In the control group, antibiotics treatment continued as long as the venous line persist, in the intervention group after day 3 to 5 if the results of blood culture were negative, the infants were checked for C-reactive protein (CRP), and if it was negative too and the patient’s clinical status was good, antibiotic treatment was stopped. The outcome measures were short-term prognosis of with VLBW newborns. Results: The mean gestational age of the studied patients was 30.21 ± 2.69 and 29.57 ± 2.09 g in the control and intervention groups, respectively (P = 0.07). The average days of receiving antibiotics in the control group were 29.21 ± 1.57 while in the intervention group it was 8.11 ± 2.16 (P 0.05). Conclusion: Early discontinuing of antibiotics (5 days or less) had no impact on the mortality rate of VLBW infants and seemed it was safe

Streptomyces Levis ABRIINW111 Inhibits SW480 Cells Growth by Apoptosis Induction

Purpose: Streptomyces sp., a dominant genus in Actinomycetes, is the source of a wide variety of secondary metabolites. Microbial metabolites can be utilized as novel anticancer agents; with fewer side effects. The present article illustrated the anti-carcinogenic effect of the ether extracted organic metabolites derived from Streptomyces bacteria on SW480 colon cancer cell line. Methods: MTT assay was performed in order to investigate the cytotoxicity effect of metabolites on SW480 cells. Apoptosis and cell cycle arrests were measured by flowcytometry. Morphological changes were indicated by Propidium iodide staining andP53 gene expression was evaluated by real-time PCR. Results: Streptomyces Levis ABRIINW111 inhibited cell growth, increased Caspases 3 and reduced Ki67 expression in a concentration/time-dependent manner in SW40 cells. Metabolites increased subG1 phase (apoptosis) and also cell cycle arrest in G1, G­­­2/M and S phase. P53 gene expression followed Sw480 cells treatment significantly. Conclusion: Streptomyces sp. metabolites have anti-carcinogenic effect on colon cancer cells. Streptomyces Levis ABRIINW111 metabolites are a candidate for Colon cancer treatment

Remifentanil versus Fentanyl for pain control during elective endotracheal intubation for surfactant administration in preterm infants

Introduction: Today, the reality of pain in neonates is an undisputed fact, but pain management in clinical practice remains a challenging issue. All neonatal units should have a pain management protocol. The aim of this study was to compare the effectiveness of Remifentanil versus Fentanyl in pain control during elective endotracheal intubation for surfactant administration in preterm infants. Materials and methods: Preterm infants with gestational age between 28 weeks and 34 weeks + 6 days with Respiratory Distress Syndrome (RDS) who needed surfactant administration were divided into two groups using a random sampling method. Neonates in the first group received 2 μg/kg intravenous Fentanyl infusion and neonates in group 2 received 1 μg/kg intravenous Remifentanil before elective endotracheal intubation for surfactant therapy. The vital signs, including heart rate, oxygen saturation, mean arterial blood pressure and change in facial grimace were documented in an unnamed Premature Infant Pain Profile-Revised (PIPP-R) scoring sheet individually. Video recording was performed in both groups before, during and after the endotracheal intubation. All videos and data were interpreted and scored by two Newborn Individualized Developmental Care and Assessment Program (NIDCAP) professionals. Results: The mean PIPP-R score in the Fentanyl-treated group was 13.06 ± 3.55 and in the Remifentanil-treated group was 10.75 ± 2.93, with no statistically significant difference (p = 0.054). There was less need for Naloxone use in the Remifentanil group (p < 0.001). Incidence of apnea, severe drop in oxygen saturation, Intra-Ventricular Hemorrhage (IVH) and chest rigidity were not significantly different between the two groups. Conclusion: Although the difference was not statistically significant, Remifentanil reduced the pain score more than Fentanyl during elective endotracheal intubation in preterm infants. We recommend conducting further studies with larger study populations to determine the better drug and the optimal dosage of these drugs in neonates