Early-Onset Neonatal Sepsis and Antibiotic Use in Northeast Thailand

Pakaphan Kiatchoosakun; Junya Jirapradittha; Prapassara Sirikarn; Malinee Laopaiboon; Porjai Pattanittum; Woranart Chandrakachorn; Sakulrat Srirojana; Heather Jeffery; Sally Green; Pagakrong Lumbiganon; on behalf of the SEA-URCHIN Study Group

doi:10.1055/s-0038-1676829

American Journal of Perinatology, Table of Contents

Am J Perinatol 2019; 36(12): 1295-1303
DOI: 10.1055/s-0038-1676829

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Early-Onset Neonatal Sepsis and Antibiotic Use in Northeast Thailand

Authors

Pakaphan Kiatchoosakun

¹Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Junya Jirapradittha

¹Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Prapassara Sirikarn

²Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
Malinee Laopaiboon

²Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
Porjai Pattanittum

²Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
Woranart Chandrakachorn

³Department of Pediatrics, Khon Kaen Hospital, Khon Kaen, Thailand
Sakulrat Srirojana

⁴Department of Pediatrics, Kalasin Hospital, Kalasin, Thailand
Heather Jeffery

⁵International Maternal and Child Health, School of Public Health, University of Sydney, Sydney, Australia
Sally Green

⁶School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
Pagakrong Lumbiganon

¹Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand

on behalf of the SEA-URCHIN Study Group

Abstract

Objective Antibiotics are commonly prescribed in neonatal intensive care units (NICUs) for suspected sepsis because of the nonspecific clinical symptoms of sepsis. The overuse of antibiotic is associated with adverse outcomes. This study aimed to determine the rate of early-onset sepsis (EOS) and antibiotic use in neonates admitted to three NICUs in Northeast Thailand

Study Design This is a descriptive study using the data collected in the South East Asia—Using Research for Change in Hospital-acquired Infection in Neonates project. Neonates admitted within 3 days of life were included. EOS was defined as neonates who presented with three or more clinical signs or laboratory results suggested sepsis and received antibiotics for at least 5 days. Those with positive blood culture were culture-proven EOS. Antibiotic use within 3 days of life and up to 28 days was described.

Results Among 1,897 neonates, 160 cases were classified as EOS (8.4%) with culture-proven EOS in 4 cases (0.2%). The median durations of antibiotic use in culture-proven and culture-negative EOSs were 15 and 8 days, respectively.

Conclusion The rate of culture-proven EOS was low, but there was a high rate of antibiotic use. Antibiotic stewardship should be emphasized.

Keywords

early-onset sepsis - neonate - antibiotic use - Thailand

Full Text

References

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