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. 2023 Sep;43(9):1145-1151.
doi: 10.1038/s41372-023-01720-6. Epub 2023 Jul 12.

Short-course antibiotic therapy for pneumonia in the neonatal intensive care unit

Zachery S Lewald  1   2   3   4 , Pavel Prusakov  5 , Jacqueline K Magers  5 , Matthew J Kielt  2   3 , Concepción de Alba Romero  2   3   6 , Natalie O White  7 , Randy R Miller  7 , Richard Moraille  8 , Anthony R Theile  8 , Pablo J Sánchez  9   10   11 ; Nationwide Children’s Hospital Neonatal Antimicrobial Stewardship Program (NEO-ASP)
Collaborators, Affiliations

Short-course antibiotic therapy for pneumonia in the neonatal intensive care unit

Zachery S Lewald et al. J Perinatol. 2023 Sep.

Abstract

Objective: To determine the adherence and safety outcomes of a 5-day antibiotic course with a "time-out" for treatment of "blood culture-negative" pneumonia in the NICU.

Study design: Prospective surveillance of all infants diagnosed with pneumonia at 7 NICUs from 8/2020-12/2021. Safety outcomes were defined a priori by re-initiation of antibiotic therapy within 14 days after discontinuation and overall and sepsis-related mortality.

Results: 128 infants were diagnosed with 136 episodes of pneumonia; 88% (n = 119) were treated with 5 days of definitive antibiotic therapy. Antibiotics were restarted within 14 days in 22 (16%) of the 136 pneumonia episodes. However, only 3 (3%) of the 119 episodes of pneumonia treated for 5 days had antibiotics restarted for pneumonia. Mortality was 5% (7/128); 5 of the 7 deaths were assessed as sepsis-related.

Conclusion: Adherence to the 5-day definitive antibiotic treatment for "culture-negative" pneumonia was high and the intervention seemed safe.

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References

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