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Am J Perinatol 2019; 36(12): 1295-1303
DOI: 10.1055/s-0038-1676829
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Early-Onset Neonatal Sepsis and Antibiotic Use in Northeast Thailand

Authors

  • Pakaphan Kiatchoosakun

    1   Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand

  • Junya Jirapradittha

    1   Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand

  • Prapassara Sirikarn

    2   Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand

  • Malinee Laopaiboon

    2   Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand

  • Porjai Pattanittum

    2   Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand

  • Woranart Chandrakachorn

    3   Department of Pediatrics, Khon Kaen Hospital, Khon Kaen, Thailand

  • Sakulrat Srirojana

    4   Department of Pediatrics, Kalasin Hospital, Kalasin, Thailand

  • Heather Jeffery

    5   International Maternal and Child Health, School of Public Health, University of Sydney, Sydney, Australia

  • Sally Green

    6   School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia

  • Pagakrong Lumbiganon

    1   Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
    • on behalf of the SEA-URCHIN Study Group
Further Information

Publication History

20 October 2018

16 November 2018

Publication Date:
31 December 2018 (online)

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Abstract

Objective Antibiotics are commonly prescribed in neonatal intensive care units (NICUs) for suspected sepsis because of the nonspecific clinical symptoms of sepsis. The overuse of antibiotic is associated with adverse outcomes. This study aimed to determine the rate of early-onset sepsis (EOS) and antibiotic use in neonates admitted to three NICUs in Northeast Thailand

Study Design This is a descriptive study using the data collected in the South East Asia—Using Research for Change in Hospital-acquired Infection in Neonates project. Neonates admitted within 3 days of life were included. EOS was defined as neonates who presented with three or more clinical signs or laboratory results suggested sepsis and received antibiotics for at least 5 days. Those with positive blood culture were culture-proven EOS. Antibiotic use within 3 days of life and up to 28 days was described.

Results Among 1,897 neonates, 160 cases were classified as EOS (8.4%) with culture-proven EOS in 4 cases (0.2%). The median durations of antibiotic use in culture-proven and culture-negative EOSs were 15 and 8 days, respectively.

Conclusion The rate of culture-proven EOS was low, but there was a high rate of antibiotic use. Antibiotic stewardship should be emphasized.

Keywords

early-onset sepsis - neonate - antibiotic use - Thailand