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Interleukin‐8: a valuable tool to restrict antibiotic therapy in newborn infants
Author(s) -
Franz AR,
Steinbach G,
Kron M,
Pohlandt F
Publication year - 2001
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2001.tb01359.x
Subject(s) - medicine , antibiotics , antibiotic therapy , c reactive protein , gastroenterology , pediatrics , prospective cohort study , inflammation , microbiology and biotechnology , biology
This study was conducted to evaluate the accuracy and kinetics of interleukin 8 (IL‐8) as a test for early‐onset bacterial infections (EOBI) in neonates and to examine whether IL‐8 would allow “unnecessary” antibiotic therapy to be reduced. First, IL‐8 was measured 378 times on admission, along with C‐reactive protein (CRP), immature to total neutrophil ratio (IT ratio) and blood cultures, in full‐term and preterm neonates with suspected EOBI. Combined culture‐proven and clinical EOBI were detected on admission by the combination of IL‐8 ≥ 70 pg ml −1 and/or CRP > 10 mg 1 −1 with 92% sensitivity and 74% specificity. An increased IL‐8 was found in 62% of the infected infants, while CRP was still normal. In a second study period, IL‐8 was determined prospectively in 331 infants who presented clinical signs of EOBI or had a birth history of amniotic infection. Antibiotic therapy was restricted to those infants with suspected infection who also had an increased IL‐8 and/or CRP ( n = 158). Another 39 infants received antibiotics on the basis of clinical signs despite negative IL‐8 and CRP. Of 150 non‐infected infants in whom IT ratio, IL‐8 and CRP were available, treatment would have been indicated for 93 infants based on IT ratio and/or CRP ( n = 77) or clinical signs ( n = 16), but was only initiated in 55 infants based on IL‐8 and/or CRP ( n = 28) or clinical signs ( n = 27), an apparent reduction in “unnecessary” antibiotic therapy of 40%. Conclusion : The combination of IL‐8 and CRP is a reliable test for the diagnosis of EOBI and may be helpful in enabling antibiotic therapy to be reduced in newborn infants.