* Hypothesis: The investigators hypothesized that Pentoxifylline has potent anti-inflammatory effect which can augment the antimicrobial effect of antibiotics in treatment of Late onset sepsis (LOS) in preterm infants thus decreasing neonatal mortality and morbidity. * The purpose of this study: to assess the efficacy and safety of Pentoxifylline as an adjunct to antibiotic therapy on mortality and morbidity of preterm infants with LOS.
* Role of pentoxifylline, a phosphodiesterase inhibitor, in reducing mortality associated with neonatal sepsis is not well studied. * Hypothesis: we hypothesized that Pentoxifylline has potent anti-inflammatory effect which can augment the antimicrobial effect of antibiotics in treatment of Late onset sepsis (LOS) in preterm infants thus decreasing neonatal mortality and morbidity. * Purpose of the study: to assess the efficacy and safety of Pentoxifylline as an adjunct to antibiotic therapy on mortality and morbidity of preterm infants with LOS. * Design: A prospective, randomized, double-blind clinical trial. * Setting: Neonatal Intensive Care Unit, Mansoura University Children's Hospital. * Patients: 120 preterm infants with suspected or confirmed LOS. * Intervention: Enrolled infants were randomly assigned to receive intravenous Pentoxifylline (5 mg/kg/hr for 6 hours on 6 successive days) or placebo in addition to antibiotics. * Primary outcome: Death before hospital discharge. * Secondary outcomes: Length of hospital stay, duration of respiratory support, duration of antibiotics use, chronic lung disease, necrotizing enterocolitis, intraventricular hemorrhage, periventricular leukomalacia, retinopathy of prematurity, Serum levels of Tumor necrosis factor, C-Reactive protein levels, and adverse effects of Pentoxifylline.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
120
Patients were randomly assigned to receive intravenous Pentoxifylline 5 mg/kg/hr for 6 hours on 6 successive days in addition to antibiotics
Patients were randomly assigned to receive intravenous normal saline 5 mg/kg/hr for 6 hours on 6 successive days as a placebo in addition to antibiotics.
Mansoura University Children Hospital
Al Mansurah, Eldakahlia, Egypt
Neonatal mortality
Mortality before discharge from neonatal intensive care unit
Time frame: Expected 10 weeks postnatal age
Length of hospital stay
Duration of hospital admission (days)
Time frame: Expected average of 8 weeks post natal age
Duration of respiratory support
Duration of respiratory support including oxygen, Continuous Positive Airway Pressure, mechanical ventilation(days)
Time frame: Expected 4 to 6 weeks postnatal age
Duration of antibiotics use
Duration of treatment of sepsis including meningitis
Time frame: Expected 3 to 5 weeks postnatal age
Chronic lung disease
Need for oxygen by 36 weeks corrected gestational age
Time frame: By 36 weeks corrected gestational age
Necrotising enterocolitis
Bell clinical and radiological criteria
Time frame: Expected 6 weeks
Intraventricular haemorrhage
By cranial ultrasound grading
Time frame: Expected 2 weeks
Periventricular leukomalacia
By cranial ultrasound
Time frame: Expected 8 weeks
Retinopathy of prematurity
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Ophthalmologist using Ret-Cam
Time frame: Expected 8 weeks
Serum levels of Tumor necrosis factor-α, C-Reactive protein
Time frame: 6 days after intervention
Adverse effects of Pentoxifylline
Adverse effects of Pentoxifylline such as feeding intolerance, thrombocytopenia and cholestasis.
Time frame: Up to 10 days after intervention