Aim To assess the choice of antibiotics in correlation to clinical management of suspected or confirmed early onset neonatal sepsis. To identify the requirement for updating our practice within the East of England Neonatal Network.
Background Clinical practice within the network is facilitated by a regional guideline and a relevant clinical guidance tool from the National Institute for Health and Clinical Excellence (NICE-149, August 2012).
Methods Prospective study from September 2012 until May 2013. 17 participating neonatal units within the network. 10 cases from each unit were included. These referred to term or preterm infants who required intravenous antibiotics for suspected or confirmed early onset sepsis with a minimum length of stay of 10 days. The data were analysed using SPSS 17.0.
Results 15 units participated. 149 babies were recruited with a mean gestational age of 32+2 weeks. 91.3% of babies received intravenous benzyl penicillin and gentamicin as first line treatment. In 25% of cases there were prescribing issues regarding gentamicin. 20.1% received cefotaxime. 19.5% of babies underwent a lumbar puncture. 17.5% of babies received antifungal agents. In 15.4% of which as treatment.
Conclusions The overall outcome was positive with prompt recognition of risk factors and initiation of treatment across all units. This unified policy promotes good quality of care. However, the percentage of prescribing issues regarding gentamicin was worryingly high. Hence, further studies and review of literature are required to evaluate the efficiency of our practice and to establish alternative choice of antibiotics.