ArticlePaediatric drugs2020
A Prospective Cohort Study of Factors Associated with Empiric Antibiotic De-escalation in Neonates Suspected with Early Onset Sepsis (EOS).
Article in Paediatric drugs, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 5 citations in OpenAlex.
- "Overview of Global Challenges in Dealing with Neonatal Sepsis and Responsibility of Healthcare Workers": A Narrative Review.Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine · 2026Review
- Risk factors associated with extended spectrum beta lactamaseAntimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Diagnostic Value of Umbilical Cord Blood Interleukin-6 Level in Premature Infants with Early-Onset Sepsis.Children (Basel, Switzerland) · 2025Article
- Successful Control of an Outbreak by Phenotypically Identified Extended-Spectrum Beta-Lactamase-ProducingAntibiotics (Basel, Switzerland) · 2022Article
- Time to Positivity of Blood Cultures Could Inform Decisions on Antibiotics Administration in Neonatal Early-Onset Sepsis.Antibiotics (Basel, Switzerland) · 2021Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundProlonged empiric antibiotic use, resulting from diagnostic uncertainties, in suspected early onset sepsis (EOS) cases constitutes a significant problem. Unnecessary antibiotic use increases the risk of antibiotic resistance. Furthermore, prolonged antibiotic use increases the risk of mortality and morbidity in neonates. Proactive measures including empiric antibiotic de-escalation are crucial to overcome these problems.
methodsThis was a prospective cohort study conducted in the neonatal intensive care units of two public hospitals in Malaysia. Neonates with a gestational age greater than 34 weeks who were started on empiric antibiotics within 72 h of life were screened. The data were then stratified according to de-escalation and non-de-escalation practices, where de-escalation practice was defined as narrowing down or discontinuation of empiric antibiotic within 72 h of treatment.
resultsA total of 1045 neonates were screened, and 429 were included. The neonates were then divided based on de-escalation (n = 207) and non-de-escalation (n = 222) practices. Neonates under non-de-escalation practices showed significantly longer durations of antibiotic use compared to those under de-escalation practices (p < 0.05), with no difference in treatment outcomes. Five factors were found to be associated with de-escalation of antibiotics. They are cesarean section delivery, exposure to antenatal steroids, nil history of maternal pyrexia, absence of meconium-stained amniotic fluid, and normal C-reactive protein ≤ 0.5 mg/dL (p < 0.05).
conclusionsEmpiric antibiotic de-escalation appears feasible as a routine form of treatment for EOS in late preterm and term neonates.
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