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Antibiotics
Special Issues
Neonatal Infections: Epidemiology, Diagnostics and Antibiotic Therapeutics
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Neonatal Infections: Epidemiology, Diagnostics and Antibiotic Therapeutics

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotic Therapy in Infectious Diseases".

Deadline for manuscript submissions: 10 November 2024 | Viewed by 505

Special Issue Editor

Prof. Dr. Frans B. Plötz

E-Mail Website
Guest Editor
1. Department of Paediatrics, Tergooi Hospital, Hilversum, The Netherlands
2. Department of Paediatrics, Amsterdam University Medical Centers-Emma Children's Hospital, Amsterdam, The Netherlands
Interests: neonatal sepsis; pediatric health care evaluation

Special Issue Information

Dear Colleagues,

Antibiotics are the most commonly prescribed drugs in the newborn period. The clinical challenge of predicting which neonates will develop a life-threatening infection often leads to a cautious approach, resulting in antibiotics bring prescribed at a relatively low threshold. Conversely, there is growing understanding that early antibiotic administration for the health of these neonates is associated with negative consequences. Short-term negative consequences include separation of parents and newborn, invasive painful procedures (with possible long-term consequences for brain development), and unnecessary hospitalization with associated costs. In the longer term, there are significant disadvantages for the microbiome and immune system, found to be associated with obesity, eczema, asthma, and diabetes later in lifeIn addition, at the population level, overuse of antibiotics leads to resistant infections that are difficult to treat. These findings underscore the need to significantly lower unnecessary antibiotic prescriptions. Therefore, the main subject of this Special Issue is how to decrease the neonatal antibiotic burden. Areas of interest include the potential of novel, targeted preventive measures, new diagnostic methods, the implementation of innovative strategies, and neonatal antibiotic stewardship.

Prof. Dr. Frans B. Plötz
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • newborn
  • infant
  • neonate
  • infection
  • sepsis
  • early-onset sepsis
  • late-onset sepsis
  • antibiotics
  • antibiotic stewardship

Published Papers (1 paper)

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Research

11 pages, 232 KiB  
Article
Factors Associated with Prolonged Antibiotic Therapy in Neonates with Suspected Early-Onset Sepsis
by Bo M. van der Weijden, Jolien R. van Dorth, Niek B. Achten and Frans B. Plötz
Antibiotics 2024, 13(5), 388; https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics13050388 - 25 Apr 2024
Viewed by 400
Abstract
Early-onset sepsis (EOS) is a rare but profoundly serious bacterial infection. Neonates at risk of EOS are often treated with antibiotics. The start of empiric antibiotic therapy can successfully be reduced by the implementation of the EOS calculator. However, once started, antibiotic therapy [...] Read more.
Early-onset sepsis (EOS) is a rare but profoundly serious bacterial infection. Neonates at risk of EOS are often treated with antibiotics. The start of empiric antibiotic therapy can successfully be reduced by the implementation of the EOS calculator. However, once started, antibiotic therapy is often continued despite a negative blood culture. To decrease the burden of antibiotic therapy, it is necessary to know whether the clinician’s reasons are based on objective factors. Therefore, we performed a retrospective single-centre cohort study to identify the factors associated with prolongation of antibiotic therapy in neonates with suspected EOS but a negative blood culture. Maternal, clinical, and laboratory data of neonates with a gestational age of ≥32 weeks, admitted between January 2019 and June 2021, were collected. Among neonates with a negative blood culture, we compared neonates with prolonged (≥3 days) to neonates with discontinued (<3 days) antibiotic therapy. The clinician’s reported reasons for prolonging therapy were explored. Blood cultures were positive in 4/146 (2.7%), negative in 131/146 (89.7%), and not obtained in 11/146 (7.5%) of the neonates. The incidence of EOS was 0.7 per 1000 neonates. Of the 131 neonates with a negative blood culture, 47 neonates (35.9%) received prolonged antibiotic therapy. In the prolonged group, the mean gestational age was higher (38.9 versus 36.8 weeks), and spontaneous preterm birth was less prevalent (21.3% versus 53.6%). Prolonged treatment was associated with late onset of respiratory distress, respiratory rate, hypoxia, apnoea and bradycardia, pale appearance, behavioural change, and elevated CRP levels. The most reported reasons were clinical appearance (38.3%), elevated CRP levels (36.2%), and skin colour (10.6%). Prolonging empiric antibiotic therapy despite a negative blood culture is common in suspected EOS. Clinical signs associated with prolongation are uncommon and the reported reasons for prolongation contain subjective assessments and arbitrary interpretations that are not supported by the guideline recommendations as arguments for prolonged therapy. Full article
(This article belongs to the Special Issue Neonatal Infections: Epidemiology, Diagnostics and Antibiotic Therapeutics)
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