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. 2023 Jun;43(6):741-745.
doi: 10.1038/s41372-023-01634-3. Epub 2023 Feb 22.

Short-course empiric antibiotic therapy for possible early-onset sepsis in the NICU

Pablo J Sánchez #  1 , Pavel Prusakov #  2 , Concepción de Alba Romero  3   4 , Elena Zamora-Flores  3   5 , María Camila Reyes Escamilla  3   6 , Natalie O White  7 , Randy R Miller  7 , Richard Moraille  8 , Anthony R Theile  8 , Jacqueline K Magers  9 ; Nationwide Children’s Hospital Neonatal Antimicrobial Stewardship Program (NEO-ASP)
Collaborators, Affiliations

Short-course empiric antibiotic therapy for possible early-onset sepsis in the NICU

Pablo J Sánchez et al. J Perinatol. 2023 Jun.

Abstract

Objective: On 2/2019, the Neonatal Antimicrobial Stewardship Program at Nationwide Children's Hospital recommended reducing empirical antibiotic therapy for early-onset sepsis (EOS) from 48 to 24 hours with a TIME-OUT. We describe our experience with this guideline and assess its safety.

Methods: Retrospective review of newborns evaluated for possible EOS at 6 NICUs from 12/2018-7/2019. Safety endpoints were re-initiation of antibiotics within 7 days after discontinuation of the initial course, positive bacterial blood or cerebrospinal fluid culture in the 7 days after antibiotic discontinuation, and overall and sepsis-related mortality.

Result: Among 414 newborns evaluated for EOS, 196 (47%) received a 24 hour rule-out sepsis antibiotic course while 218 (53%) were managed with a 48 hour course. The 24-hour rule-out group were less likely to have antibiotics re-initiated and did not differ in the other predefined safety endpoints.

Conclusion: Antibiotic therapy for suspected EOS may be discontinued safely within 24 hours.

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References

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