Ampicillin and Gentamicin for Suspected Early-Onset Sepsis: Improve On or Move On?

Sunday, April 30, 2023

11:00 AM – 12:30 PM ET

Location: Convention Center: 151 B

CE: Live CME: 1.50

Selected By: PIDS Independent
Co-sponsored By: AAP SoNPM

Chair(s)

Dustin Flannery, DO, MSCE (he/him/his)

Assistant Professor of Pediatrics
Childrens Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
Karen Puopolo, MD, PhD (she/her/hers)

Professor of Pediatrics
Perelman School of Medicine at the University of Pennsylvania
Philadelphia, Pennsylvania, United States

Disclosure(s):

Dustin D. Flannery, DO, MSCE: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Karen M. Puopolo, MD, PhD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Session

Description: Ampicillin and gentamicin are recommended by the American Academy of Pediatrics (AAP) as the most appropriate primary regimen for both term and preterm infants at risk for early-onset sepsis (EOS). Accordingly, these two drugs are the most common discretionary medications administered to newborns. EOS risk assessment continues to evolve over time, and antibiotic stewardship efforts have targeted early antibiotic use among newborns. Recent evidence suggests that antibiotic resistance, a leading global health threat, is increasing among organisms that cause EOS. In light of this, it is unclear whether ampicillin and gentamicin remain the most appropriate empiric regimen. A broader-spectrum regimen could target more potential infecting organisms, yet could lead to increased resistance and other adverse consequences. This Hot Topic Symposia will discuss the current state of EOS antibiotic use and antibiotic resistance, highlight both the pros and cons of maintaining the currently recommended empiric regimen of ampicillin and gentamicin versus other potential regimens, and review state-of-the-art pharmacologic considerations for empiric treatment. The content will be applicable to attendees who practice general pediatrics, neonatology, infectious diseases, hospital medicine, emergency medicine, and pharmacy.

Learning Objectives:

To describe current state of EOS antibiotic use and antibiotic resistance
To discuss pros and cons of the currently recommended empiric ampicillin and gentamicin regimen
To discuss pharmacologic considerations of empiric treatment for EOS

Presentations:

11:00 AM – 11:20 AM ET

1) Opening and Introductions (5min); 2) Current State of EOS Antibiotic Use and Antibiotic Resistance (20min)
Speaker: Dustin D. Flannery, DO, MSCE (he/him/his) – Childrens Hospital of Philadelphia
11:20 AM – 11:35 AM ET

PK / PD Considerations for Empiric Antibiotic Dosing During EOS Evaluations
Speaker: Kelly Wade, MD PhD MSCE (she/her/hers) – Childrens Hospital of Philadelphia, University of Pennsylvania
11:35 AM – 11:50 AM ET

Ampicillin and Gentamicin: An Amicable Separation is in Order
Speaker: David J. Burchfield, MD (he/him/his) – University of Florida College of Medicine
11:50 AM – 12:05 PM ET

Ampicillin and Gentamicin: Still the Best (Most of the Time…)
Speaker: Karen M. Puopolo, MD, PhD (she/her/hers) – Perelman School of Medicine at the University of Pennsylvania
12:05 PM – 12:25 PM ET

Discussion and Q&A
12:25 PM – 12:30 PM ET

Closing Remarks
Speaker: Karen M. Puopolo, MD, PhD (she/her/hers) – Perelman School of Medicine at the University of Pennsylvania