Antibiotic prescribing in neonatal sepsis: an Australian nationwide survey.
AuthorMcMullan, B; Cooper, C; Spotswood, N; James, R; Jones, C; Konecny, P; Blyth, C; Karen, T
Source TitleBMJ Paediatr Open
University of Melbourne Author/sMcMullan, Brendan
Document TypeJournal Article
CitationsMcMullan, B., Cooper, C., Spotswood, N., James, R., Jones, C., Konecny, P., Blyth, C. & Karen, T. (2020). Antibiotic prescribing in neonatal sepsis: an Australian nationwide survey.. BMJ Paediatr Open, 4 (1), pp.e000643-. https://doi.org/10.1136/bmjpo-2020-000643.
Access StatusOpen Access
Open Access at PMChttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC7101048
Objective: To evaluate quality and variation in antibiotic prescribing for neonatal sepsis. Design: We analysed prescribing in hospitalised neonates using the National Antimicrobial Prescribing Survey in Australian neonates from 1 January 2014 to 31 December 2018. Setting: Data from antibiotic point prevalence surveys performed in hospitals, ranging from rural hospitals to tertiary paediatric and maternity hospitals within Australia. Patients: Admitted neonates <28 days of age from participating hospitals. Main outcome measures: Variation and appropriateness in prescribing for neonatal sepsis and variation in dosing for gentamicin and benzylpenicillin across hospitals. Results: A total of 415 prescriptions among 214 neonates from 39 different hospitals were included. The majority of prescriptions (342, 82.4%) were for neonates <7 days of age. The most commonly prescribed antibiotics were gentamicin and benzylpenicillin, with 323 (77.8%) prescriptions. Dosing variability was substantial, with doses ranging from 2 to 8 mg/kg for gentamicin (median 5 mg/kg, IQR 4-5) and from 45 to 72 mg/kg for benzylpenicillin (median 60 mg/kg, IQR 50-60), although only 13 (3.2%) and 19 (4.6%) prescriptions were locally assessed as inappropriate or non-compliant with guidelines, respectively. At time of audit, 22% of antibiotics had been given for more than 48 hours and 9% more than 72 hours, although microbiologically confirmed infection was documented in only nine (4.2%) neonates. Conclusions: Prescribing for neonatal sepsis was dominated by use of benzylpenicillin and gentamicin with substantial variation in dosing. A small minority had culture-confirmed infection. Efforts to standardise antibiotic dosing and duration for suspected neonatal sepsis are recommended.
- Click on "Export Reference in RIS Format" and choose "open with... Endnote".
- Click on "Export Reference in RIS Format". Login to Refworks, go to References => Import References