Anemia of Prematurity - Portal Neonatal

Pediatric Dose
neoformans. Polyene antibiotic produced by a strain of Streptomyces
nodosus; can be fungistatic or fungicidal. Binds to sterols, such as
ergosterol, in fungal cell membrane, causing intracellular components to
leak and subsequent fungal cell death.
Test dose: 0.1 mg/kg/dose IV; not to exceed 1 mg/dose infused over
20-60 min or 0.25 mg/kg infused over 6 h; if tolerated, administer 0.25
mg/kg/d; gradually increase dose by 0.25-mg/kg/d increments until
desired daily dose reached
Maintenance dose: 0.25-1 mg/kg/d IV qd infused over 4-6 h; administer
total dosage of 30-35 mg/kg over 6 wk
Contraindications Documented hypersensitivity
Interactions
Coadministration with other nephrotoxic drugs (eg, antineoplastic
agents, aminoglycosides, vancomycin, cyclosporine) may enhance
renal toxicity; antineoplastic agents may increase risk of bronchospasm
and hypotension; corticosteroids, digitalis, and thiazides may potentiate
hypokalemia
Pregnancy B - Usually safe but benefits must outweigh the risks.
Precautions
Determine BUN and serum creatinine levels qod while therapy is
increased and at least weekly thereafter; monitor serum potassium and
magnesium closely; check electrolytes, CBC, liver function studies,
input and output, BP, and temperature regularly; administer slowly
because cardiovascular collapse reported after rapid injection
FOLLOW-UP Section 8 of 11
Further Outpatient Care: The primary care provider should follow up with the infant within one week
of discharge from the hospital. The infant can be evaluated for superinfection associated with
antibiotic therapy, especially if the therapy was prolonged. Determine if the feeding regimen and
activity have returned to normal. Stress to the family the importance of adhering to the immunization
schedule.
Transfer:
• The infant may require transfer to a level III perinatal center, especially if he or she requires
cardiopulmonary support and/or parenteral nutrition.
• The multidisciplinary services available are necessary when treating a neonate with acute
compromise.
Deterrence/Prevention: The Committee on Infectious Diseases of the AAP recommends that
obstetric care include a strategy to manage early-onset GBS disease. Treat women with GBS
bacteriuria during pregnancy when it is diagnosed and at delivery. The committee also recommends
that women who have previously given birth to an infant with GBS disease be intrapartally treated.
Practitioners should use either a strategy based on screening the mother or a strategy based on the
presence of intrapartum risk factors to minimize the risk of early-onset GBS disease.
Complications: Infants with meningitis may acquire hydrocephalus and/or periventricular
leukomalacia. They may also have complications associated with the use of aminoglycosides, such
as hearing loss and/or nephrotoxicity.
Prognosis: With early diagnosis and treatment, infants are not likely to experience long-term health
problems associated with neonatal sepsis; however, if early signs and/or risk factors are missed, the
mortality rate increases. Residual neurologic damage occurs in 15-30% of neonates with septic
meningitis.