Routine antibiotic use in preterm neonates: a randomised controlled trial

The Journal of Hospital Infection
A TagareA Pandit

Abstract

The immature immune system of preterm neonates puts them at higher risk of neonatal sepsis. We conducted a part-blinded randomised controlled trial to compare the effect of routine antibiotic treatment on the incidence of clinical sepsis in preterm neonates. Preterm neonates without other risk factors for infection admitted in the first 12h of life were randomised to receive routine antibiotics or to a control group (no antibiotics unless clinically indicated). The primary outcome variable was the incidence of clinical sepsis. Secondary outcomes were the incidence of positive blood cultures, necrotising enterocolitis (NEC) stage II or III, or death, and the duration of hospital stay. The incidence of clinical sepsis was comparable in both groups (intervention 31.9%, control 25.4%; P=0.392). Mortality was equivalent in both groups. The control group had significantly more positive blood cultures (P=0.002). The incidence of NEC and the duration of hospital stay were comparable in both groups. In low risk preterm neonates we found no evidence that routine antibiotic use has a protective effect.

References

Jan 15, 2000·Archives of Disease in Childhood. Fetal and Neonatal Edition·D Isaacs
Oct 3, 2002·Pediatrics·Terri B HydeUNKNOWN Active Bacterial Core surveillance (ABCs) of the Emerging Infections Program Network
Aug 19, 2007·Indian Journal of Pediatrics·B V S KrishnaM R Chandrasekhar

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Citations

Jan 15, 2013·ISRN Gastroenterology·Thomas Peter Fox, Charles Godavitarne
Sep 8, 2011·Pediatrics International : Official Journal of the Japan Pediatric Society·Tuuli MetsvahtIrja Lutsar
Jun 19, 2015·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·L MolesR Del Campo
Apr 4, 2017·The Journal of Antimicrobial Chemotherapy·Eirin EsaiassenClaus Klingenberg
Dec 23, 2017·Maternal Health, Neonatology and Perinatology·Sheila M GephartJennifer Duchon
May 9, 2019·World Journal of Clinical Pediatrics·Yu-Ting JinJing Lin

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