Occurrence of hyperbilirubinemia in neonates given a short-term course of ceftriaxone versus cefotaxime for sepsis

Garrett B. Hile, Kaitlin L. Musick, Adam J. Dugan, Abby M. Bailey, Gavin T. Howington

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

OBJECTIVE Ceftriaxone and cefotaxime are appealing options for the treatment of neonatal infections. Guidelines recommend cefotaxime as the cephalosporin of choice in neonates because of ceftriaxone’s potential to cause hyperbilirubinemia. Unfortunately, due to cefotaxime discontinuation, providers must choose between alternative antibiotics. Clinicians at our institution adopted a protocol allowing for the utilization of cefepime and ceftriaxone for the management of neonatal sepsis. The objective of this study was to compare the incidence of hyperbilirubinemia between ceftriaxone and cefotaxime in the treatment of neonatal infections beyond the first 14 days of life. METHODS This was a retrospective chart review of patients receiving ceftriaxone or cefotaxime for the treatment of neonatal infections. Patients were 15 to 30 days old at the time of antimicrobial administration and received at least 1 dose of ceftriaxone or cefotaxime during hospital admission. Patient characteristics and bilirubin levels were compared between ceftriaxone and cefotaxime. RESULTS The analysis included 88 patients. There was no statistically significant difference between groups in age, gestational age, weight, and baseline total calcium and bilirubin levels. Normal baseline bilirubin levels increased to an abnormal level after antibiotic administration in 2 patients in the cefotaxime group and 1 patient in the ceftriaxone group. The median number of doses of cefotaxime and ceftriaxone were 3 and 2, respectively. CONCLUSION Patients who received a short-term course of ceftriaxone did not have a higher likelihood of developing hyperbilirubinemia compared with those who received a short-term course of cefotaxime during their hospital stay.

Original languageEnglish
Pages (from-to)99-103
Number of pages5
JournalJournal of Pediatric Pharmacology and Therapeutics
Volume26
Issue number1
DOIs
StatePublished - 2021

Bibliographical note

Publisher Copyright:
© Pediatric Pharmacy Association. All rights reserved.

Keywords

  • Adverse drug effect
  • Albumin
  • Cefotaxime
  • Ceftriaxone
  • Hyperbilirubinemia
  • Neonatal sepsis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pharmacology (medical)

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