Evaluation Of Empirical Antibiotic Therapy For Suspected Neonatal Early-onset Sepsis

Objective:Evaluation the rationality of empirical antibiotic therapy for suspected neonatal early-onset sepsis.Methods:Retrospective observational study of antibiotic use was performed on suspected early-onset neonates in Children's Hospital of Chongqing Medical University(CHCMU)in June and July 2015.Divided all cases into non-sepsis and sepsis group by the final clinical diagnosis.General information,first-choice antibiotic type,course of the treatment,antibiotic regimens,indications and inappropriate use for initiation and continuation of antibiotics were recorded.Results:Of totally 217 suspected cases,122 cases belonged to non-sepsis while 95 cases were sepsis.And 201cases(92.6%)were received empirical antibiotic therapy once hospitalized,first-choice antibiotic mostly were penicillin+ latamoxef,non-sepsis group account for 68.4% and sepsis group 64.5%.While 51cases(23.5%)changed antibiotic type when superior physicians ward round in the second hospital stay.Non-sepsis group inappropriate initiation of antibiotic use(within 72 hours of use)were 16 cases(13.1%),including 9 cases(7.4%)didn't take an antibiotic,7 cases(5.7%)antibacterial spectrum didn't cover common pathogenic bacteria;inappropriate continuation of antibiotic use(after 72 hours of use)were 77 cases(63.1%),including 42cases(34.4%)didn't cease antibiotics timely when sepsis was excluded,14 cases(11.5%)didn't reevaluate,21 cases(17.2%)didn't reevaluate timely.Sepsis group inappropriate initiation of antibiotic use were 9 cases(9.5%),including 5 cases(5.3%)didn't take an antibiotic,4 cases(4.2%)antibacterial spectrum didn't cover common pathogenic bacteria;inappropriate continuation of antibiotic use were 49 cases(51.6%),including 21 cases(22.1%)didn't cease antibiotics when infection were cured,18 cases(18.9%)didn't reevaluate timely,9 cases(9.5%)didn't reevaluate.Non-sepsis group was remarkable by didn't stop using antibiotics timely when sepsis was excluded(34.4%),while sepsis group was didn't stop using antibiotics when infection was cured(22.1%).Conclusions: Inappropriate empirical antibiotic therapy use for suspected neonatal early-onset sepsis is serious,setting up neonatal antimicrobial stewardship team to standard antibiotic use in neonatal ward is needed.