Short course versus 7-day course of intravenous antibiotics for probable neonatal septicemia: a pilot, open-label, randomized controlled trial.

Abstract

OBJECTIVE:

To compare a short course of antibiotics (48 to 96 hours) and a standard course of antibiotics (7 days) for probable neonatal sepsis.

DESIGN:

Randomized, controlled, open-labeled trial with blocking and stratification according to birth weight.

SETTING:

Tertiary care, referral, teaching hospital in Northern India.

PARTICIPANTS:

Neonates >30 wks gestation and >1000 g at birth, with probable sepsis (clinical signs of sepsis, raised C reactive protein) were enrolled. Babies with major malformations, severe birth asphyxia, meningitis, bone or joint or deep-seated infection, those who were already on antibiotics, and those undergoing surgery were excluded. Neonates, who had clinically remitted on antibiotic therapy by the time a sterile blood culture report was received were randomized.

INTERVENTION:

In the intervention arm, antibiotics were stopped after the 48 hour culture was reported sterile. In the control arm, antibiotics were continued to a total of 7 days.

MAIN OUTCOME MEASURE:

Treatment failure defined as reappearance of signs suggestive of sepsis within 15 days of stopping antibiotics, supported by laboratory evidence and adjudicated by a blinded expert committee.

RESULTS:

52 neonates were randomized to receive a short course or 7 day course (n=26 each). Baseline variables were balanced in the 2 groups. There was no significant difference in the treatment failures between the 2 groups (3 babies in the 7-day group vs none in short course group, P=0.23).

CONCLUSION:

No difference in the treatment failure rates could be identified between short course and 7-day groups among neonates >30 weeks and > 1000 grams with probable sepsis.

• Authors: Shiv Sajan Saini, Sourabh Dutta, Pallab Ray, Anil Narang
• Journal: Indian pediatrics (Indian Pediatr) Vol. 48 Issue 1 Pg. 19-24 (Jan 2011) ISSN: 0974-7559 [Electronic] India
• PMID: 20972299 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Anti-Bacterial Agents

Topics

• Anti-Bacterial Agents (administration & dosage)
• Bacteremia (drug therapy, microbiology)
• Chi-Square Distribution
• Drug Administration Schedule
• Humans
• Infant, Newborn
• Infant, Newborn, Diseases (drug therapy, microbiology)
• Injections, Intravenous
• Pilot Projects
• Treatment Failure