Pentoxifylline for treatment of sepsis and necrotizing enterocolitis in neonates

Pammi, Mohan; Haque, Khalid N.

doi:10.1002/14651858.cd004205.pub3

Cited by 62 publications

(64 citation statements)

References 35 publications

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“…Pentoxifylline is a phosphodiesterase inhibitor that suppresses TNF-α production and has other antiinflammatory actions (Haque and Pammi, 2011). A meta-analysis of six RCTs investigating the effect of intravenous pentoxfylline as an adjunct to antibiotic therapy to prevent mortality or morbidity from suspected or proven sepsis found pentoxifylline was associated with a significant decrease in all-cause mortality (Pammi and Haque, 2015) but only 416 infants have been studied and the evidence is lowquality. Only one trial assessed risk of ROP as a secondary outcome with no benefit seen from pentoxifylline compared with antibiotics alone (Pammi and Haque, 2015).…”

Section: Anti-inflammatory Therapy and Ropmentioning

confidence: 99%

Pathophysiology, screening and treatment of ROP: A multi-disciplinary perspective

Chan‐Ling

Gole

Quinn

et al. 2018

Progress in Retinal and Eye Research

125

107

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The population of infants at risk for retinopathy of prematurity (ROP) varies by world region; in countries with well developed neonatal intensive care services, the highest risk infants are those born at less than 28 weeks gestational age (GA) and less than 1 kg at birth, while, in regions where many aspects of neonatal intensive and ophthalmological care are not routinely available, more mature infants up to 2000 g at birth and 37 weeks GA are also at risk for severe ROP. Treatment options for both groups of patients include standard retinal laser photocoagulation or, more recently, intravitreal anti-VEGF drugs. In addition to detection and treatment of ROP, this review highlights new opportunities created by telemedicine, where screening and diagnosis of ROP in remote locations can be undertaken by non-ophthalmologists using digital fundus cameras. The ophthalmological care of the ROP infant is undertaken in the wider context of neonatal care and general wellbeing of the infant. Because of this context, this review takes a multi-disciplinary perspective with contributions from retinal vascular biologists, pediatric ophthalmologists, an epidemiologist and a neonatologist. This review highlights the latest insights regarding cellular and molecular mechanisms in the formation of the retinal vasculature in the human infant, pathogenesis of ROP, detection and treatment of severe ROP, the risks and benefits of anti-VEGF therapy, the identification of new therapies over the horizon, and the optimal neonatal care regimen for best ROP outcomes, and the benefits and pitfalls of telemedicine in the remote screening and diagnosis of ROP, all of which have the potential to improve ROP outcomes.

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Section: Anti-inflammatory Therapy and Ropmentioning

confidence: 99%

Pathophysiology, screening and treatment of ROP: A multi-disciplinary perspective

Chan‐Ling

Gole

Quinn

et al. 2018

Progress in Retinal and Eye Research

125

107

View full text Add to dashboard Cite

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“…Pentoxifylline is one of these agents studied but a very weak evidence found for usage as combination therapy to antbiotics in neonatal sepsis in a Cochrane review with a relative risk of NEC of 0.62 [101] [102]. In another study which intra-peritoneal pentoxifylline used in neonatal rat model, it was found that NEC incidence and severity reduced [103].…”

Section: New Medical Treatments In Researchmentioning

confidence: 99%

New Frontiers of Necrotizing Enterocolitis: From Pathophysiology to Treatment

Zubarioglu¹,

Uslu²,

Bülbül³

2017

Health

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Necrotizing enterocolitis [NEC] is an inflammatory disease of intestine largely occuring in preterm infants with a wide range of damage from minimal injury limited to mucosa to extensive necrosis of bowel wall and perforation. Despite advancements in neonatal care, mortality remains high [30% -50%] and controversy still persists with regards to the most appropriate management of neonates with necrotizing enterocolitis. The main factors thought to be involved in the pathogenesis of NEC are: relatively hyper-reactive state of premature intestine, enteral feeding and bacterial colonization. In this review, we discuss current knowledge about the epidemiology, pathophysiology, imaging, medical and surgical management of necrotizing enterocolitis and describe novel strategies for prevention and treatment.

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“…Particularly, it has been suggested that PTX could be beneficial for sepsis in preterm neonates. A recent Cochrane review including 6 relatively small studies showed that PTX improves survival in neonatal sepsis [1]. How can PTX, initially developed for a completely different population and indication, save premature newborns with sepsis?…”

Section: Introductionmentioning

confidence: 99%