Improving antibiotic prescribing in neonatal units: time to act: Table 1

Russell, Alison; Sharland, Mike; Heath, Paul T

doi:10.1136/adc.2007.120709

Cited by 65 publications

(67 citation statements)

References 39 publications

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“…In this study, vancomycin was prescribed on average for 9 days and cefotaxime for 6 days. This is in agreement with Russel et al [14] who recommend a minimum of 5 days of treatment in case of negative microbiologic examinations, 14 days in case Staphylococcus aureus infection, and 21 days in case of meningeal involvement. Measurements of PCT should enable a choice of more individual, objective and adapted duration of treatment.…”

Section: Discussionsupporting

confidence: 80%

“…However, they were obtained, using a protocol routinely implemented in our service, which was developed from the use of antimicrobials reported by others [14]. In our series, we did not report severe sepsis that may modify the evolution of PCT value and the evaluation of duration of treatment.…”

Section: Discussionmentioning

confidence: 99%

“…There is no study that allows to precisely identifying the antimicrobial regimens most appropriate for the treatment and the duration [14]. The first-line antimicrobials that are recommended are vancomycin, gentamicin and cefotaxime, while meropenem can be prescribed as second-line treatment.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Contributions of Procalcitonin in the Treatment of Neonatal Late Onset Sepsis: A Prospective Observational Study

Mesniladelée¹,

Champion²,

Kieffer³

et al. 2016

J Preg Child Health

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Contributions of Procalcitonin in the Treatment of Neonatal Late Onset Sepsis: A Prospective Observational Study

Mesniladelée¹,

Champion²,

Kieffer³

et al. 2016

J Preg Child Health

View full text Add to dashboard Cite

show abstract

“…Because of the high mortality linked with EOS, antibiotics are rapidly introduced, sometimes even before culture, the latter becoming less sensitive. In this context, molecular detection of the pathogen could be very useful, because it should increase sensitivity and rapidity of the identification of pathogens, permitting the cessation of treatment of suspected EOS at 48 h if the 'septic screen' is negative [47].…”

Section: Molecular Diagnosis Of Neonatal Sepsismentioning

confidence: 99%

Molecular-based Screening for Perinatal Group B Streptococcal Infection: Implications for Prevention and Therapy

2013

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Group B streptococci (GBS) are a leading cause of infectious neonatal morbidity and mortality. Timely and accurate identification of colonized pregnant women is imperative to implement intrapartum antibioprophylaxis (IAP) to reduce the risk of early neonatal sepsis. Current guidelines recommend screening for GBS carriage with vaginal-rectal cultures. However, cultures require 24-72 h, thus precluding their use for intrapartum screening and these are only performed at 35-37 weeks gestation. New rapid molecular-based tests can detect GBS within hours. They have the potential to be used intrapartum and to allow for selective IAP in women carrying GBS. An advantage is that they can sometimes be performed by non-laboratory staff in the labor suite, thus avoiding delays in sample transfers to the microbiology laboratory. Another possible use of molecular-based assays is for the diagnosis of neonatal sepsis, where tests with a short turnaround time and high sensitivity and specificity are crucial. In this situation, the detection of microorganisms once antibiotic therapy has already been started is important, as treatment is started immediately once sepsis is suspected without waiting for microbiological confirmation. In this article, we discuss the state-of-the-art molecular-based tests available for GBS screening during pregnancy, as well as their implications for IAP for the diagnosis and prevention of neonatal sepsis.

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“…Use of antibiotics has been associated with altered gut flora [23,24] and an increased risk of necrotising enterocolitis in infants [25,26,27]. Infants are also at risk of the ototoxic and nephrotoxic side effects of gentamicin [28] and vancomycin [29,30].…”

Section: Discussionmentioning

confidence: 99%

A Sterile Collection Bundle Intervention Reduces the Recovery of Bacteria from Neonatal Blood Culture

et al. 2018

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Background: In neonatal intensive care, coagulase-negative Staphylococcus species can be both blood culture contaminants and pathogens. False-positive cultures can result in clinical uncertainty and unnecessary antibiotic use. Objective: This study sought to assess whether a sterile blood culture collection bundle would reduce the incidence of false-positive blood cultures in a regional neonatal intensive care unit. Method: Clinical data was collected from all infants who had blood cultures taken before and after the introduction of the sterile blood culture collection bundle intervention. This intervention required 2% chlorhexidine and full sterile precautions for blood culture collection. False-positive blood culture rates (presence of skin commensals and ≥3 clinical infection signs) were compared before and after the intervention. The number of days of unnecessary antibiotics associated with false-positive blood cultures was also analysed. Results: In the pre-intervention group (PRE) 197 cultures were taken from 161 babies. In the post-intervention group (POST) 170 cultures from 133 babies were acquired. Baseline demographics were similar in both groups. The rate of false-positive cultures in the PRE group versus the POST group was 9/197 (4.6%) compared to 1/170 (0.6%) (p < 0.05). Unnecessary antibiotic exposure was reduced in the PRE group in comparison to the POST group (27 vs. 0 days, p < 0.01). Conclusions: Implementation of sterile blood culture collection intervention reduced the number of false-positive results. This has potential benefit in reducing unnecessary antibiotic use.

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Improving antibiotic prescribing in neonatal units: time to act: Table 1

Cited by 65 publications

References 39 publications

Contributions of Procalcitonin in the Treatment of Neonatal Late Onset Sepsis: A Prospective Observational Study

Contributions of Procalcitonin in the Treatment of Neonatal Late Onset Sepsis: A Prospective Observational Study

Molecular-based Screening for Perinatal Group B Streptococcal Infection: Implications for Prevention and Therapy

A Sterile Collection Bundle Intervention Reduces the Recovery of Bacteria from Neonatal Blood Culture

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