Effects of pentoxifylline on coagulation profile and disseminated intravascular coagulation incidence in Egyptian septic neonates

Abstract

Pentoxifylline protects against sepsis-induced microcirculatory derangement in neonates. It significantly lowered the incidence of bleeding and MODS and shortened the length of hospital stay.

Pentoxifylline Therapy for Late-Onset Sepsis in Preterm Infants

“…PTX therapy in conjunction with antibiotics did not decrease the development of NEC. 14,[19][20][21][22][23][24] An interesting finding in our study is that the length of hospital stay, duration of antibiotics therapy and duration of respiratory support were significantly lower in preterm infants who received PTX. The latest Cochrane review has demonstrated that there is no reduction in the development of NEC in neonates with sepsis who had PTX as an adjunct to antibiotics compared with neonates with sepsis who had placebo [typical relative risk: 0.29 (95% CI: 0.07-1.24); typical RD: −0.20 (95% CI: −0.41 to 0.01)], and they also clarified that no completed randomized or quasi-randomized trials using PTX for the treatment of stage II or III NEC were identified.…”

“…13 Few studies have evaluated the potential value of PTX as an adjuvant therapy in NS, but the current evidence is weakened by methodological issues in the included studied, and hence, the routine use of PTX in NS has not been recommended. A recent Cochrane review, 25 including 4 small RCTs and quasi-RCTs (227 neonates), has demonstrated that there is a significant reduction in all-cause mortality during hospital stay in neonates with sepsis who had PTX as an adjunct to antibiotics compared with neonates with sepsis who had placebo [typical relative risk: 0.40 (95% CI: 0.20-0.77); typical RD: 0.15 (95% CI: −0.26 to −0.05); number needed to treat: 7 (95% CI: [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]]. This finding is in contrast to the results of a RCT 19 and a small quasi-RCT, 22 and both demonstrated significant reduction in mortality in infants receiving PTX.…”

“…[13][14][15][16][17] PTX has attracted attention of scientists since the discovery of its role in inhibition of TNF-α gene transcription and reduction of mortality from sepsis. Earlier observational, quasi-randomized and randomized trials 14,[19][20][21][22][23][24] revealed contradictory results. Earlier observational, quasi-randomized and randomized trials 14,[19][20][21][22][23][24] revealed contradictory results.…”

“…18 Current evidence regarding the efficacy of PTX in NS as an adjuvant therapy to antibiotics is not clear. [19][20][21][22][23][24] Meta-analysis of the previous trials suggested that the use of PTX as an adjunct to antibiotics in NS decreases mortality without any adverse effects; however, it highlighted considerable methodologic limitations of these trials. [19][20][21][22][23][24] Meta-analysis of the previous trials suggested that the use of PTX as an adjunct to antibiotics in NS decreases mortality without any adverse effects; however, it highlighted considerable methodologic limitations of these trials.…”

Effect of Pentoxifylline, administered in Preterm Labour, on the Foetal–Placental Circulation and Neonatal Outcome: A Randomized, Prospective Pilot Study

“…aminophylline [14]. Over the past two decades, this non-steroidal immunomodulating agent has been used in a range of infectious, vascular and inflammatory conditions, including sepsis and multiorgan dysfunction syndrome in adults and infants, and in children with Kawasaki's disease [15][16][17]. It was shown in the experimental studies that pentoxifylline reduced foetal mortality and reversed LPS-induced foetal intra-uterine growth restriction and skeletal development retardation [18].…”