EFFECTS OF ORAL GENTAMICIN IN THE PREVENTATION OF NECROTIZING ENTEROCOLITIS IN PRETERM INFANTS

Necrotizing enterocolitis is the most common acquired life threating intestinal disease in the neonates. This disease affects predominately preterm infants (less than 37 weeks gestational age). The pathogenesis of NEC is unknown predisposing. Risk factors for NEC include: lschemia, Hypotension, RDS (Respiratory distress syndrom), umbilical artery catheterization, Hypothermia, patent ductus arteriosus- early entral alimentation and infection. Clinical manifestation of NEC include: Feeding intolerance, delayed gastric emptying time, Abdominal distension tenderness, Occult blood or bloody stools, lethargy, Apnea-Respiratory distress. In progressive stage, Acidosis, shock, Bactremia and disseminated intravascular coagulation (DIC) were occured. Studied that the infection is an important ethiology of NEC,and studied effects of prophylactic oral antibiotic therapy in prevention of NEC in preterm infants, with different results. So we studied the effect of prophylactic oral Gentamicin in NEC in AliAsghar hospital on 40 preterm neonates with history of fetal distress, respiratory distress syndrome or postnatal asphyxia and umbilical artery catheterization, Hypothermia, PDA, early entral alimentation and infections. This was a clinical trial study. The 40 preterm infants with history of risk factors divided in 2 groups.(each groups 20 infants). 20 neonates were randomized selected for remedy with 5 mg/kg/day BD oral gentamicin with density 2.5 mg/ml in DW 5% for 21 days. The same as equievalent density volum of DW 5% has been given to the control group. Clinical diagnosis of NEC was based on the blood or occult blood in stool, abdominal distention, Radiologic evidence include existance of pnumatosis intestinalis and intestinal marginal edema. In controlled group (20 neonates), 5 neonates affected NEC: These were 2 (25%) of them died. In exprimental group (20 neonates), 3 neonates (15%) affected NEC that 3 of them died. At the base of this study useage of oral gentamicin had positive effects in prevention of NEC in preterm infants.