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. 2024 Jun 10;13(6):537.
doi: 10.3390/antibiotics13060537.

Incidence of Antibiotic Exposure for Suspected and Proven Neonatal Early-Onset Sepsis between 2019 and 2021: A Retrospective, Multicentre Study

Liesanne E J van Veen  1   2   3 , Bo M van der Weijden  3   4 , Niek B Achten  2 , Lotte van der Lee  4 , Jeroen Hol  5 , Maaike C van Rossem  6 , Maarten Rijpert  7 , Anna O J Oorthuys  4   8 , Ron H T van Beek  9 , Gerdien H Dubbink-Verheij  10 , René F Kornelisse  11 , Laura H van der Meer-Kapelle  12 , Karen Van Mechelen  13 , Suzanne Broekhuizen  14 , A Carin M Dassel  15 , J W F M Corrie Jacobs  16 , Paul W T van Rijssel  17 , Gerdien A Tramper-Stranders  1   2 , Annemarie M C van Rossum  2 , Frans B Plötz  3   4
Affiliations

Incidence of Antibiotic Exposure for Suspected and Proven Neonatal Early-Onset Sepsis between 2019 and 2021: A Retrospective, Multicentre Study

Liesanne E J van Veen et al. Antibiotics (Basel). .

Abstract

Management of suspected early-onset sepsis (EOS) is undergoing continuous evolution aiming to limit antibiotic overtreatment, yet current data on the level of overtreatment are only available for a select number of countries. This study aimed to determine antibiotic initiation and continuation rates for suspected EOS, along with the incidence of culture-proven EOS in The Netherlands. In this retrospective study from 2019 to 2021, data were collected from 15 Dutch hospitals, comprising 13 regional hospitals equipped with Level I-II facilities and 2 academic hospitals equipped with Level IV facilities. Data included birth rates, number of neonates started on antibiotics for suspected EOS, number of neonates that continued treatment beyond 48 h and number of neonates with culture-proven EOS. Additionally, blood culture results were documented. Data were analysed both collectively and separately for regional and academic hospitals. A total of 103,492 live-born neonates were included. In 4755 neonates (4.6%, 95% CI 4.5-4.7), antibiotic therapy was started for suspected EOS, and in 2399 neonates (2.3%, 95% CI 2.2-2.4), antibiotic treatment was continued beyond 48 h. Incidence of culture-proven EOS was 1.1 cases per 1000 live births (0.11%, 95% CI 0.09-0.14). Overall, for each culture-proven EOS case, 40.6 neonates were started on antibiotics and in 21.7 neonates therapy was continued. Large variations in treatment rates were observed across all hospitals, with the number of neonates initiated and continued on antibiotics per culture-proven EOS case varying from 4 to 90 and from 4 to 56, respectively. The high number of antibiotic prescriptions compared to the EOS incidence and wide variety in clinical practice among hospitals in The Netherlands underscore both the need and potential for a novel approach to the management of neonates with suspected EOS.

Keywords: anti-bacterial agent; antimicrobial stewardship; blood culture; early-onset sepsis; incidence; neonates.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of hospital inclusions. * The reason for the lack of response was not formally requested and is therefore not known.
Figure 2
Figure 2
Number of neonates initiated and continued >48 h on antibiotic therapy per culture-proven EOS case.
See this image and copyright information in PMC

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