Routine bathing and skin care as per hospital practice

1% aqueous CHG applied from the neck down with cotton swabs daily on weekdays (total of 8 days CHG application)

Aquaphor skin cream applied from the neck down daily on weekdays (total of 8 days emollient application)

1% aqueous CHG applied from the neck down with cotton swabs daily on weekdays followed immediately by Aquaphor skin cream (total of 8 days CHG application plus emollient application)

Neonatal SEPSIS

Prematurity

Very Low Birth Weight Baby

Bloodstream Infection

Skin antisepsis

Emollient

Tygerberg Hospital

Neonatal Bacterial Colonization Study

Impact of 1% Chlorhexidine Gluconate and/or Emollient on Neonatal Bacterial Colonization Dynamics

Darmstadt skin score uses a 9-point scale (calculated as the sum of points for each of 3 items: skin eythema, dryness and breakdown, with a minimum score of 1 and maximum score of 3, representing worst possible skin condition for each sub-scale, total sum of points is a minimum score of 3 and maximum score of 9 for worst possible skin condition)

pathogen identified on sterile site specimen (blood, urine, cerebrospinal fluid)

culture-negative episode of infection with at least 5 days broad-spectrum antibiotic therapy

Angela Dramowski

Associate Professor

University of Stellenbosch

John E. Fogarty International Center (FIC)

Enrolled babies will be sequentially recruited to one of 4 study arms (see below).

Hypothermia

St Christopher's Hospital for children

Pharmacokinetics of Ampicillin in Neonates With Moderate to Severe Hypoxic-Ischemic Encephalopathy

Pharmacokinetics of Ampicillin in Neonates With Moderate to Severe Hypoxic-Ischemic Encephalopathy Undergoing Controlled Hypothermia

Ampicillin concentration at 3 time points to determine clearance and serum levels

Ogechukwu Menkiti

Drexel University

Neonates randomized to intervention Group(Antibiotic group)will receive the first line antibiotics (Piperacillin-Tazobactam and Amikacin) as per the unit policy for 72 hours. These neonates will also be monitored by performing sepsis screens and blood culture for development of sepsis.

Neonates randomized to 'No antibiotic group' will receive supportive treatment as per standard unit protocol. These neonates will be monitored by performing sepsis screens and blood culture for development of sepsis.

Neonatal Sepsis

Inj Piperacillin-Tazobactam 50 mg/Kg/dose 12 hourly IV X 3 days (6 doses) Inj Amikacin 15 mg/kg/dose 24 hourly IV X 3 days (3 doses)

Piperacillin-Tazobactam and Amikacin

Kalawati Saran children's Hospital, Lady Hardinge Medical College

Role of Antibiotics in Preventing Infection in Babies Born Through Meconium Stained Liquor

Role of Prophylactic Antibiotics in Preventing Neonatal Sepsis in Neonates Born Through Meconium Stained Amniotic Fluid - A Randomized Controlled Trial

Incidence of sepsis in first 28 days defined as -
SUSPECTED SEPSIS - Sepsis Screen > 2 parameters positive and/or
CONFIRMED SEPSIS - Sepsis Screen positive + Blood or CSF culture positive for bacteria.
Sepsis Screen
Total leukocyte count < 5000/mm3
Absolute neutrophil count < 1800/cu.mm.(Low counts as per Monroe chart for term neonates)
Immature/total neutrophil ratio > 0.2
Micro-ESR > 15mm in 1st hour
C Reactive Protein (CRP) > 1 mg/dl

Requirement of respiratory support
The mode of respiratory support viz. Supplemetal Oxygen therapy, CPAP, Mechanical ventilation, High Frequency ventilation
Duration of each kind of respiratory support required

Incidence of PPHN by Echocardiography, Pneumothorax by transillumination confirmed by chest x-ray, azotemia by Kidney function test panel

neonatal sepsis/hypoxia

Neonatal Bacterial Colonization Study

Pharmacokinetics of Ampicillin in Neonates With Moderate to Severe Hypoxic-Ischemic Encephalopathy

Role of Antibiotics in Preventing Infection in Babies Born Through Meconium Stained Liquor

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