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Multicentre study found that adherence to national antibiotic recommendations for neonatal early‐onset sepsis was low
Author(s) -
Weijden Bo M.,
Achten Niek B.,
Bekhof Jolita,
Evers Esther E.,
Berk Mylène,
Kamps Arvid W.A.,
Rijpert Maarten,
ten Tusscher Gavin W.,
Houten Marlies A.,
Plötz Frans B.
Publication year - 2021
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.15488
Subject(s) - medicine , antibiotics , observational study , sepsis , neonatal sepsis , blood culture , pediatrics , prospective cohort study , gestation , intensive care medicine , pregnancy , genetics , microbiology and biotechnology , biology
Aim Our aim was to evaluate adherence to the Dutch neonatal early‐onset sepsis (EOS) guidelines, adapted from UK guidance. We also looked at the effect on antibiotic recommendations and duration. Method This was a multicentre, prospective observational cross‐sectional study carried out in seven hospitals in the Netherlands between 1 September 2018 and 1 November 2019. We enrolled 1024 neonates born at 32 weeks of gestation or later if they demonstrated at least one EOS risk factor or clinical signs of infection. Results The Dutch guidelines recommended antibiotic treatment for 438/1024 (42.8%) of the neonates designated at risk, but only 186/438 (42.5%) received antibiotics. The guidelines advised withholding antibiotics for 586/1024 (57.2%) of neonates and in 570/586 (97.3%) cases the clinicians adhered to this recommendation. Blood cultures were obtained for 182/186 (97.8%) infants who started antibiotics and only four were positive, for group B streptococci. Antibiotic treatment was continued for more than 3 days in 56/178 (31.5%) neonates, despite a negative blood culture. Conclusion Low adherence to the Dutch guidelines meant that the majority of neonates did not receive the antibiotic treatment that was recommended, while some antibiotic use was prolonged despite negative blood cultures. The guidelines need to be revised.