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S J Oddie

Publications and source records attributed to S J Oddie.

3 recordsLinked to original sources

Early discharge and readmission to hospital in the first month of life in the Northern Region of the UK during 1998: a case cohort study.

AIMS: To study the frequency and associations of early postpartum discharge and infant readmission to hospital. METHODS: Infants readmitted to hospital during the first 28 days of life in 1998 in the Northern Region of the UK were studied. RESULTS: A total of 4743 of 11,338 (42%) babies were discharged on or before the first postnatal day. Rates of early discharge varied significantly between hospitals. Infants <2500 g at birth (adjusted odds ratio (AOR) 0.44, 95% CI 0.29 to 0.66), infants 35-37 weeks gestation at birth (AOR 0.65, 95% CI 0.49 to 0.86), and firstborn infants (AOR 0.09, 95% CI 0.08 to 0.10) were less likely to be discharged early. Women from more deprived areas were more likely to be discharged early (AOR 1.37, 95% CI 1.12 to 1.67). A total of 907 of 32,015 (2.8%) babies liveborn in the region were readmitted to hospital during 1998. Readmission rates varied significantly by hospital of birth but not by timing of discharge. Babies <2500 g at birth (AOR 1.95, 95% CI 1.16 to 3.28) and babies born at 35-37 weeks gestation (AOR 1.72, 95% CI 1.15 to 2.57) were more likely to be readmitted. Breast fed babies were less likely to be readmitted (AOR 0.69, 95% CI 0.53 to 0.90). Infants initially discharged early were not more likely to be readmitted. CONCLUSIONS: Early discharge occurred variably in the Northern Region in 1998. It is not associated with readmission to hospital. Breast feeding is associated with lower rates of readmission to hospital.

England↗

An extended interval dosing method for gentamicin in neonates.

Traditional gentamicin dosing every 8-24 h depending on age and weight in neonates does not provide the ideal concentration-time profile to both optimize the concentration-dependent killing by aminoglycosides and minimize toxicity. Fifty-three neonates were audited prospectively while receiving gentamicin 2.5 mg/kg every 8-24 h, aiming for peak concentrations (Cmax) of 6-10 mg/L and trough concentrations (Cmin) <2 mg/L. After the first dose, the mean (+/- s.d.) Cmax was 5.5 +/- 0.7 mg/L with sub-therapeutic concentrations (<6 mg/L) in 62% of patients, while the mean Cmin was >2 mg/L in 15% of the neonates. After the third dose the Cmax was 7.5 +/- 1.5 mg/L, with 17% <6 mg/L, whereas the mean Cmin was 2.2 +/- 1.1 mg/L with 49% of values >2 mg/L. An extended interval dosing method (24, 36 and 48 h) for infant weights of 0.75-5 kg was developed by simulation, and audited prospectively in 51 neonates. Prospective analysis of the extended interval dosing method showed a mean Cmax after the first dose of 13.1 +/- 3.6 mg/L, while the mean Cmin was 0.7 +/- 0.6 mg/L. Seventy-eight per cent had Cmax of >10 mg/L after the first dose. The mean area under the concentration versus time curve AUC0-24 was 93 mg*h/L (target = 100 mg*h/L). The extended interval dosing achieved higher Cmax values while ensuring that overall exposure per 24 h was acceptable. Prospective testing of the method demonstrated good predictive ability.

Anti-Bacterial Agents↗