Use Judiciously, or I Will Be Useless” A Clinical Audit on Use of Antibiotics Within First 72 hrs of Life in Symptomatic Term Babies With no Maternal Risk for Infection

Abstract

Over use of antibiotics lead to resistance and unwanted sideeffects in newborns. Since 1992, professional societies or public health agencies have issued several generations of recommendations for prevention or management of early-onset neonatal sepsis (EOS) [1-5]. Despite these efforts, recommendations remain inconsistent, clarifications are necessary, local adaptations are common, and compliance rates are low [6-7]. It is common clinical practice to discontinue antibiotic treatment of asymptomatic babies if the blood cultures are negative at 48 hours [8-10]. But it is very common to have prolonged antibiotic courses for more than 48 hours due to delayed release of blood culture, high CRP, abnormal CBC or delayed decision by the Physician to stop antibiotics. In a previous study, McDonald et al. [11] found this as a common occurrence in neonatal intensive care units. The purpose of this audit is to rationalize the use of antibiotics in symptomatic term babies, with no risk for infection.