Antibiotic Use in Late Preterm and Full-Term Newborns

Area of Science:

• Neonatal care
• Infectious diseases
• Pharmacology

Background:

• Antibiotic treatment is crucial for neonatal sepsis but overuse can lead to antibiotic resistance and adverse outcomes.
• Optimizing antibiotic use in newborns requires robust surveillance data.

Purpose of the Study:

• To examine the association between antibiotic use and the incidence and mortality of early-onset sepsis (EOS) in late-preterm and full-term newborns.
• To provide data for optimizing antibiotic treatment strategies in neonatal care.

Main Methods:

• A nationwide observational study in Sweden (2012-2020) included all live births from 34 weeks' gestation.
• Data were sourced from the Swedish Neonatal Quality Register and Swedish Medical Birth Register.
• Analysis focused on antibiotic exposure, culture-proven EOS, and associated mortality.

Main Results:

• Over 1 million newborns were included; 1.88% received antibiotics in the first week of life.
• The incidence of EOS decreased significantly from 0.74 to 0.34 per 1000 live births (2012-2020).
• EOS-associated mortality was 1.39% and did not change significantly; antibiotic use was not linked to increased EOS risk or mortality.

Conclusions:

• Low exposure to antibiotics in newborns was not associated with increased EOS risk or mortality.
• Despite stable antibiotic use, further reduction of unwarranted antibiotic prescriptions in neonates is recommended.
• This study highlights the need for continued surveillance to refine neonatal antibiotic stewardship.