Antibiotic exposure for culture-negative early-onset sepsis in late-preterm and term newborns: an international study
Permanent lenke
https://hdl.handle.net/10037/35425Dato
2024-09-17Type
Journal articleTidsskriftartikkel
Peer reviewed
Forfatter
Dimopoulou, Varvara; Klingenberg, Claus Andreas; Navér, Lars; Nordberg, Viveka; Berardi, Alberto; el Helou, Salhab; Fusch, Gerhard; Bliss, Joseph M.; Lehnick, Dirk; Guerina, Nicholas; Seliga-Siwecka, Joanna; Maton, Pierre; Lagae, Donatienne; Mari, Judit; Janota, Jan; Agyeman, Philipp K. A.; Pfister, Riccardo; Latorre, Giuseppe; Maffei, Gianfranco; Laforgia, Nicola; Mózes, Enikő; Størdal, Ketil; Strunk, Tobias; Stocker, Martin; Giannoni, Eric; Aleksandra, Zwijacz; Kristyna, Zilinska; Martin, Trefny; Stensvold, Hans Jørgen; Damber, Shrestha; Rønnestad, Arild Erland; Vittoria, Rizzo; Frida, Oldendorff; Anne-Louise, Kollegger; Sharandeep, Kaur; Stellan, Håkansson; Bartłomiej, Grochowski; Carmelo, Geraci; Alessandra, Foglianese; Rana, Esmaeilizand; Zoe, el Helou; Khalyane, Eap; Pietro, Drimaco; Morena, De Angelis; Martina, Ceccoli; Grazia, Capretti MariaSammendrag
Methods - We conducted a retrospective analysis across eleven countries in Europe, North America, and Australia. All late-preterm and term infants born between 2014 and 2018 who received intravenous antibiotics during the first postnatal week were classified as culture-negative cases treated for ≥5 days (CN ≥ 5d), culture-negative cases treated for <5 days (CN < 5d), or CP-EOS cases.
Results - Out of 757,979 infants, 21,703 (2.9%) received intravenous antibiotics. The number of infants classified as CN ≥ 5d, CN < 5d, and CP-EOS was 7996 (37%), 13,330 (61%), and 375 (1.7%). The incidence of CN ≥ 5d, CN < 5d, and CP-EOS was 10.6 (95% CI 10.3–10.8), 17.6 (95% CI 17.3–17.9), and 0.49 (95% CI 0.44–0.54) cases per 1000 livebirths. The median (IQR) number of antibiotic days administered for CN ≥ 5d, CN < 5d, and CP-EOS was 77 (77–78), 53 (52–53), and 5 (5-5) per 1000 livebirths.
Conclusions - CN ≥ 5d substantially contributed to the overall antibiotic exposure, and was 21-fold more frequent than CP-EOS. Antimicrobial stewardship programs should focus on shortening antibiotic treatment for culture-negative cases.