Abstract
Background:
With increasing antibiotic resistance, and an extremely vulnerable patient group, judicious use of antibiotics on the NICU is required to achieve appropriate pathogen coverage. To understand current practice, we aimed to compare UK NICU guidelines for early and late onset sepsis (EoS and LoS) against National Institute for Health and Care Excellence (NICE) recommendations.
Methods:
Between January and May 2024, we contacted UK NICU’s via email/telephone and requested their antibiotic guidelines.
Results:
We obtained guidelines from 53/53 (100%) NICUs. in-line with NICE guidance, the EoS recommendation was primarily benzylpenicillin and an aminoglycoside 96% (51/53); Largely consistent across gestations, Gentamicin was the most used aminoglycoside 85% (45/53). 4% (2/53) used a cephalosporin as monotherapy. 21% (11/53) specified second line antibiotics for EoS, with
significant agent variance. For LoS, 98% (52/53) of units had guidelines for empiric first line antibiotics; agents varied widely, with 77% (41/53) using narrow spectrum, in-line with NICE guidance. The combination of flucloxacillin and gentamicin was the most common 54% (29/53). 54% (29/53) of units had recommendations for infants with indwelling central venous catheters (CVC). There were many combinations, the most widely used single agent being vancomycin 60% (32/53), used in combination with Gentamicin in 18% (10/53).
Gentamicin was used, in combination with other agents, in 58% (31/53) of units. Pipercillintazobactam and Teicoplanin were both used in 13% of units (7/53) respectively. There were 2 units with different recommendations for preterms with indwelling CVC. A second line agent for LoS was specified in 73% (38/53) units, but the agents varied widely, the most common second line combination being vancomycin and gentamicin, in 18% (10/53) NICUs
Conclusion:
Many units dictate no specific antibiotics for LoS in preterm infants, practice is varied in infants with indwelling CVCs. This potentially reflects these situations not being addressed in current NICE guidance.
With increasing antibiotic resistance, and an extremely vulnerable patient group, judicious use of antibiotics on the NICU is required to achieve appropriate pathogen coverage. To understand current practice, we aimed to compare UK NICU guidelines for early and late onset sepsis (EoS and LoS) against National Institute for Health and Care Excellence (NICE) recommendations.
Methods:
Between January and May 2024, we contacted UK NICU’s via email/telephone and requested their antibiotic guidelines.
Results:
We obtained guidelines from 53/53 (100%) NICUs. in-line with NICE guidance, the EoS recommendation was primarily benzylpenicillin and an aminoglycoside 96% (51/53); Largely consistent across gestations, Gentamicin was the most used aminoglycoside 85% (45/53). 4% (2/53) used a cephalosporin as monotherapy. 21% (11/53) specified second line antibiotics for EoS, with
significant agent variance. For LoS, 98% (52/53) of units had guidelines for empiric first line antibiotics; agents varied widely, with 77% (41/53) using narrow spectrum, in-line with NICE guidance. The combination of flucloxacillin and gentamicin was the most common 54% (29/53). 54% (29/53) of units had recommendations for infants with indwelling central venous catheters (CVC). There were many combinations, the most widely used single agent being vancomycin 60% (32/53), used in combination with Gentamicin in 18% (10/53).
Gentamicin was used, in combination with other agents, in 58% (31/53) of units. Pipercillintazobactam and Teicoplanin were both used in 13% of units (7/53) respectively. There were 2 units with different recommendations for preterms with indwelling CVC. A second line agent for LoS was specified in 73% (38/53) units, but the agents varied widely, the most common second line combination being vancomycin and gentamicin, in 18% (10/53) NICUs
Conclusion:
Many units dictate no specific antibiotics for LoS in preterm infants, practice is varied in infants with indwelling CVCs. This potentially reflects these situations not being addressed in current NICE guidance.
| Original language | English |
|---|---|
| Pages | 182 |
| Number of pages | 1 |
| Publication status | Published - 10 Sept 2024 |
| Event | British Association of Perinatal Medicine (BAPM) Annual Conference - Sheffield, United Kingdom Duration: 10 Sept 2024 → 11 Sept 2024 |
Conference
| Conference | British Association of Perinatal Medicine (BAPM) Annual Conference |
|---|---|
| Country/Territory | United Kingdom |
| City | Sheffield |
| Period | 10/09/24 → 11/09/24 |