Background: Treatment and prophylaxis of sepsis in very low birth weight neonates is a matter of concern and\r\nresearch is being undertaken with the aim to give rise to shared approaches based on solid evidence. As part of a\r\nEuropean initiative, a survey was set up to describe the use of two drugs in this area. The Italian national practices\r\nconcerning neonatal sepsis, as well as calls for related guidance, are described.\r\nMethods: A standardized and previously tested questionnaire was submitted online to all Italian level III NICUs.\r\nA 5-point Likert scale was used to analyze attitudinal replies. Categorical variables were compared by ?2 analysis\r\nand 2-tailed P-values are reported.\r\nResults: Data was provided by 38 Italian NICUs (36% of the countryââ?¬â?¢s level III centers), 53% of which have 1ââ?¬â??10\r\ncases of bacterial sepsis monthly and 90% a prevalence of <1% fungal infections. Ciprofloxacin and fluconazole\r\ntreatment for neonatal sepsis are scantly used in Italian NICUs (13% and 45%, respectively). Major concerns are\r\nrelated to the safety of ciprofloxacin and the efficacy of fluconazole. On the contrary, prophylaxis of fungal\r\ninfections is a routine approach in many Italian NICUs. The use of both ciprofloxacin and fluconazole is\r\ncharacterized by a large inter-NICU variability in dose and scheme of use. The lack of adequate, shared evidence is\r\na common consideration made by the survey participants.\r\nConclusions: Common approaches are needed to standardize and update a national drug strategy for the\r\nprevention and treatment of sepsis in very low birth weight newborns. This can be achieved through collaborative\r\ninitiatives aimed at setting up guidelines, based on available data, and multicenter trials to produce new evidence\r\nthat will address the knowledge gaps.
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