Benefits of bi-antibiotherapy in the treatment of neonatal bacterial infection in a secondary care hospital in a resource-limited setting

Calixte Ida Penda; Daniele Mangamba Kedy Koum; Paul Olivier Koki Ndombo; Gorgie Monny Elimbi; Juste Patient Mbebi-Enone; Enyama Dominique; Hassanatou Iyawa Ousmanou; Patricia Epee Eboumbou; Grace Dallé Ngondi; Charlotte Eposse Ekoube; Sena Muna Penda; Clotilde Njall Pouth; Julien Mang Mani; Ritha Mbono Betoko; Cécile Okala Ebongue

Authors

Calixte Ida Penda Author
Daniele Mangamba Kedy Koum Author
Paul Olivier Koki Ndombo Author
Gorgie Monny Elimbi Author
Juste Patient Mbebi-Enone Author
Enyama Dominique Author
Hassanatou Iyawa Ousmanou Author
Patricia Epee Eboumbou Author
Grace Dallé Ngondi Author
Charlotte Eposse Ekoube Author
Sena Muna Penda Author
Clotilde Njall Pouth Author
Julien Mang Mani Author
Ritha Mbono Betoko Author
Cécile Okala Ebongue Author

Keywords:

Therapeutic recommendations, Neonatal sepsis, Newborns, Cameroon

Abstract

Introduction. Neonatal sepsis remains a major cause of neonatal morbidity and mortality in resource-limited settings. The objective of this study was to evaluate the use of two antibiotics compared to the current triple therapy used in the neonatology department of the Douala Laquintinie Hospital (DHL). Methodology. A cross-sectional study was conducted from January 1 to March 31, 2020, in the neonatology department of DHL. We included full-term or preterm babies with gestational age ≥ 34th weeks with anamnestic and/or clinical criteria for neonatal sepsis. Newborns were divided into 3 groups according to the treatment and severity criteria: Protocol 1 (Ampicillin/Gentamycin); Protocol 2 (Cefotaxime/Gentamycin) according to the High Authority for Health (HAS) and Protocol 3 (Cefotaxime/Ampicillin/Tobramycin) respectively in this unit. The length of stay, clinical outcomes and kinetics of C-reactive protein were evaluated in each group. Results. Of 320 neonates admitted for neonatal sepsis, those aged 0-7 days accounted for 94.1% of cases. Newborns under Protocol 2 had a longer length of stay than those who received Protocol 3 (p=0.015) and more children were significantly cured in Protocol 2 than in Protocol 3 (p=0.022). More than half of the newborns (n= 130) with an initial positivity of the CRP obtained a negative CRP after 72 h of treatment regardless of the protocol used. Conclusion. Dual therapy, a therapeutic recommendation of the High Authority of Health has positive results on clinical and biological recovery but with a longer length stay for newborns with gestational age higher than 34 weeks.

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