Powder Topical Rifampicin on Reducing Infections After Neural Tube Defect Surgery in Infants

Yuzuncu Yıl University

Status

Unknown

Conditions

Postoperative Infection Rates

Treatments

Drug: Local Rifampisin and İnrtravenous cefotaxime

Study type

Observational

Funder types

Other

Identifier

NCT03198819

Details and patient eligibility

About

The correct timing and technique of neural tube defect (NTD) repairs significantly decreases the morbidity and mortality of NTD cases. However, infections related to the surgery are still common. We investigated the effects of topical rifampicin (RIF) combined with routine prophylaxis in newborns with open NTD.

Full description

The study will be conducted in the Yuzuncu Yil University neonatal intensive care unit, Van, Turkey. The data of 60 neonates diagnosed with open NTD, who will be underwent surgical intervention between August 2016 and December 2017, will be prospectively evaluated. These cases will be randomised.These neonates are going to divide into two groups: the experimental group and the control group. The experimental group will be consisted of 30 newborns diagnosed with open NTDs, administered topical RIF (10 mg/kg/day, 24 h infusion) and cefotaxime (50 mg/kg/day, two doses, iv), and the control group will be consisted of 30 newborns diagnosed with open NTDs, administered cefotaxime (50 mg/kg/day, two doses).

In this study, researchers will be investigated whether prophylactic topical RIF applied on a pre-operative mesh in newborns with open NTD reduce the rate of SSIs and meningitis/ VP shunt infections after surgery. For deep incisional primary SSIs will be evaluated according to the diagnostic criteria of the United States (U.S.) Centers for Disease Control and Prevention (CDC) (1). The diagnosis of VP shunt infections will be made after extensive clinical and laboratory evaluations. the diagnosis of to make shunt infections, criteria of the Hydrocephalus Clinical Research Network (HCRN) will be taken into consideration (2).

Topical RIF Application Procedure The NTD site will be covered with a sterile gauze dressing in the first hours of life after birth in all babies with open NTDs. Then, 10 mg/kg/day RIF will be added to 24 ml of saline (0,9% NaCl), and this will be applied to the mesh as an infusion at a 1cc/h speed . Every day, the same dose of RIF will be delivered to the mesh,changed daily, as a 24-hour infusion until the patient could be operated. After the patient is operated, the RIF infusion delivered to the mesh will be stopped. The cefotaxime treatment will be continued until 72 hours post-op (3).

Enrollment

30 estimated patients

Sex

All

Ages

1 to 28 days old

Volunteers

No Healthy Volunteers

Inclusion criteria

Newborns who have open NTDs

Exclusion criteria

Healthy newborns

Trial design

30 participants in 2 patient groups

Rifampisin group

Description:

Researchers will administer topical Rifampicin and intravenous cefotaxime 1. For Rifampicin; 10 mg/kg/day, 24 h infusion on defect area during 3 days 2. For cefotaxime; 50 mg/kg/day, twice a day, intravenous during 5 days.

Treatment:

Drug: Local Rifampisin and İnrtravenous cefotaxime

Control group

Description:

Researchers will only administer intravenous cefotaxime 1) Doses; 50 mg/kg/day, twice a day, intravenous during 5 days.

Treatment:

Drug: Local Rifampisin and İnrtravenous cefotaxime