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Successful Treatment of Hyperbilirubinemia by Monitoring Serum Unbound Bilirubin in an Extremely Preterm Infant with Bacterial Infection by Izumi Kishi, Nobuhiko Nagano, Daichi Katayama, Takayuki Imaizumi, Takuya Akimoto, Kazumasa Fuwa, Ryoji Aoki, Midori Hijikata, Kazunori Kayama, Ryota Kato, Aya Okahashi, Ichiro Morioka

Background: Bacterial infections and some antibiotics show displacer effects on bilirubin-albumin binding and increase unbound bilirubin (UB) but not total bilirubin (TB) in serum.
Methods: A case study was conducted to show a successful treatment of hyperbilirubinemia by monitoring UB.
Results: In an extremely preterm infant with bloodstream bacterial infection caused by methicillin-resistant coagulase-negative staphylococci, 2 days after high-dose ampicillin and regular-dose amikacin were initiated, UB markedly increased, but TB did not. After vancomycin was substituted, UB decreased immediately with phototherapy and intravenous albumin infusion.
Conclusions: When using antibiotics, the clinicians should be mindful regarding the displacer effect on bilirubin-albumin binding.

DOI: 10.7754/Clin.Lab.2020.200508