Clinical considerations of febrile infants with respiratory symptoms according to the respiratory viral detection

PURPOSE: Respiratory viral infection is one of the most common diseases in febrile infants. This study evaluates the clinical characteristics of febrile infants who were hospitalized for respiratory symptoms, with or without respiratory viral detection. METHODS: Seventy-six hospitalized infants aged 28-90 days with fever and respiratory symptoms from January 2011 to December 2012 were enrolled in this study. We performed reverse transcriptase polymerase chain reaction to identify 7 respiratory viruses from nasopharyngeal swabs. Also, we retrospectively reviewed the medical records to analyze the clinical features. RESULTS: Respiratory viruses were detected in 45 patients (RVP group). Respiratory syncytial virus (n=16) was most frequently detected, followed by human rhinovirus (n=10). Age, sex, past illness, and sibling's respiratory symptoms showed no differences between the 2 groups. Infants in the RVP group had a significantly higher incidence of tachypnea (22.2%) and abnormal breathing sounds (wheezing and rales, 57.8%) than those in the negative group (P=0.021, P=0.002 each). There were no significant differences in laboratory findings between the 2 groups. CONCLUSION: In our study, RSV was the most common virus in febrile infants aged 28-90 days with respiratory symptoms. Tachypnea and abnormal breathing sounds were more reliable clinical features to guess the detection of respiratory viruses. Further studies are required to confirm the values of these clinical features in febrile infants who have lower respiratory tract infections.

Effect of Initial Empirical Antibiotics Duration on Neonatal Outcomes in Very Low Birth Weight Infants / 대한주산의학회잡지

PURPOSE: Little is known about the duration of antibiotics for suspected early-onset sepsis (EOS) with negative blood cultures. The purpose of this study is to identify associations between the duration of empirical antibiotics and neonatal outcomes. METHODS: We retrospectively reviewed medical records of very low birth weight infants (VLBW) who admitted to NICU in 2007-2010. We defined empirical antibiotic therapy group as those who started antibiotic therapy in first 3 postnatal days. We compared the neonatal outcomes between short empirical antibiotic therapy ( or =5 days). RESULTS: Of 122 VLBW, 72 infants were long empirical antibiotic therapy group. In the long empirical antibiotic therapy group, there were lower birth weight, higher rate of out-born, higher rate of vaginal delivery, and had lower Apgar scores. Prolonged antibiotic therapy was associated with delayed start of enteral feeding and incidence of ESBL. CONCLUSION: Prolonged antibiotic therapy may be associated with some adverse neonatal outcomes. Therefore, wide spread agreement regarding the short empirical antibiotic therapy was needed.