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Pediatric Infectious Disease Journal:
Original Studies

Topically Applied Sunflower Seed Oil Prevents Invasive Bacterial Infections in Preterm Infants in Egypt: A Randomized, Controlled Clinical Trial

Darmstadt, Gary L. MD, MS†; Badrawi, Nadia MD‡; Law, Paul A. MD, MPH*; Ahmed, Saifuddin PhD*; Bashir, Moataza MD‡; Iskander, Iman MD‡; Said, Dalia Al MD‡; Kholy, Amani El MD‡; Husein, Mohamed Hassan MD‡; Alam, Asif MBBS§; Winch, Peter J. MD, MPH*; Gipson, Reginald MD||; Santosham, Muhammad MD, MPH*

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Background: Because the therapeutic options for managing infections in neonates in developing countries are often limited, innovative approaches to preventing infections are needed. Topical therapy with skin barrier-enhancing products may be an effective strategy for improving neonatal outcomes, particularly among preterm, low birth weight infants whose skin barrier is temporarily but critically compromised as a result of immaturity.

Methods: We tested the impact of topical application of sunflower seed oil 3 times daily to preterm infants <34 weeks gestational age at the Kasr El-Aini neonatal intensive care unit at Cairo University on skin condition, rates of nosocomial infections and mortality.

Results: Treatment with sunflower seed oil (n = 51) resulted in a significant improvement in skin condition (P = 0.037) and a highly significant reduction in the incidence of nosocomial infections (adjusted incidence ratio, 0.46; 95% confidence interval, 0.26–0.81; P = 0.007) compared with infants not receiving topical prophylaxis (n = 52). There were no reported adverse events as a result of topical therapy.

Conclusions: Given the low cost (~$.20 for a course of therapy) and technologic simplicity of the intervention and the effect size observed in this study, a clinical trial with increased numbers of subjects is indicated to evaluate the potential of topical therapy to reduce infections and save newborn lives in developing countries.

© 2004 Lippincott Williams & Wilkins, Inc.


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