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Updated: Aug 8, 2026
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Published on: March 14, 2013
Antimicrobial therapy utilization in neonates with hypoxic-ischemic encephalopathy (HIE): a report from the
Rakesh Rao1, Kyong-Soon Lee2, Isabella Zaniletti3
1Pediatrics, Washington University School of Medicine, St. Louis, MO, USA. Rao_R@wustl.edu.
Objective(S):
Quantify antimicrobial therapy (AMT) use in newborns with hypoxic-ischemic encephalopathy treated with therapeutic hypothermia (HIE/TH).
Study Design:
Newborns with HIE/TH were identified from the Children's Hospital Neonatal Database (CHND). Early infection (onset ≤7 days of life) was defined as "confirmed" (culture proven) or "suspected infection" (culture negative but treated) and compared with a "no infection" group.
Results:
1501/1534 (97.8%) neonates received AMT. 36 (2.3%) had confirmed, 255 (16.6%) suspected, and 1243 (81.0%) had no infection. The median (IQR) AMT duration was 13 (8-21), 8 (7-10), and 3 (3-7) days for the three groups, respectively (p < 0.001). AMT duration of use varied significantly across centers, adjusted for covariates (OR 1.88, 95% CI: 1.43-2.46).
Conclusion(S):
Incidence of early confirmed infection in neonates with HIE/TH (23/1000) is significantly higher than reported rates of early onset sepsis in term and near term infants (0.5-1.0/1000 live births). Antimicrobial-stewardship opportunities exist in infants with negative cultures.
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