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Ellen J D Van Rossem¹, Frans B Plötz^2,3, Mariet K Felderhof¹

¹From the Department of Paediatrics, Flevo Hospital, Almere, the Netherlands.

The Pediatric infectious disease journal

|June 21, 2023

概括

荷兰关于早期发作的败血症 (EOS) 的新指南没有减少新生儿使用抗生素. 抗生素治疗的持续时间增加,对指南的遵守率下降,表明需要修订查策略.

科学领域:

新生儿医学新生儿医学
传染性疾病传染性疾病
公共卫生政策公共卫生政策

背景情况:

2017年,荷兰对新生儿早期性败血症 (EOS) 实施了一项新的指导方针,调整了英国指导方针,以关注孕产妇和新生儿的危险因素.
该指南取代了较旧的荷兰指南,主要集中在B组链球菌 (GBS) 测试和预防上.

研究的目的:

评估荷兰新的EOS指南是否比以前的指南更有效地减少疑似EOS的抗生素治疗率.
评估指导方针变更对抗生素使用模式和遵守的影响.

主要方法:

在荷兰进行了一项单一中心的回顾性队列研究.
分析了2015年 (指导方针之前) 和2019年 (指导方针之后) 两个12个月的数据.
包括新生儿接受了疑似EOS治疗或观察到高风险.

主要成果:

经验性抗生素治疗率在2015年至2019年期间保持稳定,为4.6%.
长时间的抗生素治疗 (>48小时) 从2015年的24%显著增加到2019年的39% (P=0.021).
准则的遵守率从98%下降到84% (P<0.001),EOS的发病率相当于2015年的0.6%和2019年的0.0%).
风险因素定义的变化减少了在分娩期间对母亲发烧的抗生素使用 (48%至26%,P<0.001).

结论:

荷兰新的EOS指南未能减少疑似EOS的经验性抗生素治疗.
观察到抗生素治疗的持续时间增加和指导方针的遵守程度降低.
建议采用新的新生儿败血症查策略.

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