Minimum Duration of Antibiotic Treatment Based on Blood Culture in Rule Out Neonatal Sepsis

The Pediatric Infectious Disease Journal
Naveed Ur Rehman DurraniSourabh Dutta

Abstract

Neonatologists usually wait 48 hours for blood culture results before deciding to discontinue antibiotics. The objective of the study was to analyze time to positive blood culture in rule out sepsis and estimate the minimum duration of antibiotics. Retrospective analysis of blood culture at the Neonatal Intensive Care Unit, McMaster Children's Hospital (January 2004 to December 2013) using BacT/Alert® 3D microbial system was conducted. We calculated average time taken for blood culture samples to emit a positive signal and compared it between Gram-positive and Gram-negative organisms. Kaplan-Meier curves for time to detect positive culture were generated. A Cox proportional hazard regression model with the outcome variable "time to detect positive blood culture" and predictor variables "early-onset sepsis (EOS) versus late-onset sepsis (LOS)", "Gram-positive versus Gram-negative" and "definite versus possible pathogen versus contaminant" was generated. Of 7,480 blood cultures performed in 9,254 neonates, 885 samples grew microorganisms. 845 culture reports from 627 neonates were analyzed. Definite or opportunistic pathogens caused 815 (96%) infections (54 EOS and 791 LOS) and the rest were contaminants. Gram-negative organisms ...Continue Reading

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Citations

Sep 29, 2019·Archives of Disease in Childhood·Trevor Duke, Nicole X Wong
Jul 6, 2020·Journal of Paediatrics and Child Health·Lucinda MarksJohn K Ferguson
Mar 9, 2021·Seminars in Fetal & Neonatal Medicine·Noa FleissRichard A Polin
Sep 4, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Martin StockerAnnemarie M C van Rossum
Jul 23, 2021·The Pediatric Infectious Disease Journal·Alieke van der HoevenVincent Bekker

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