ArticleArchives of disease in childhood. Fetal and neonatal edition2025
Serial physical examination to reduce unnecessary antibiotic exposure in newborn infants: a population-based study.
Article in Archives of disease in childhood. Fetal and neonatal edition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Antibiotic stewardship in the context of management of early onset neonatal sepsis-an evolving paradigm shift.World journal of clinical pediatrics · 2026Review
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesWhile antibiotics save lives in infants with sepsis, up to 12.0% of non-infected term and late preterm infants are exposed to antibiotics underscoring diagnostic challenges in early onset sepsis (EOS).This study aimed to assess whether serial physical examination (SPE) in neonatal intensive care units (NICUs) could safely reduce early antibiotic exposure in infants born at ≥34 weeks' gestation at risk for EOS.
designA population-based, multicentre interventional study from 2018 throughout 2021.
settingSix Norwegian tertiary and secondary level NICUs. PATIENTS: In total, 54 713 liveborn infants were eligible for inclusion.
interventionsInfants at risk for EOS (mild/transient clinical signs, chorioamnionitis-exposed or group B streptococcus sepsis in a sibling) were clinically monitored with SPE for 24-48 hours. Infants with no/transient clinical signs did not receive antibiotics, whereas treatment was initiated without delay if signs indicated severe EOS, clinical condition deteriorated despite intervention or vital signs failed to improve.
main outcome measuresComparative statistics were used to evaluate changes after implementing SPE, including percentage of infants exposed to antibiotics, incidence of EOS, NICU and safety outcomes (time from birth to antibiotics administration in EOS, infection-related deaths and re-admissions for infection). A statistical process control chart was used to evaluate antibiotic exposure over time.
resultsInfants exposed to antibiotics were reduced by 50%, from 1.8% (95% CI 1.6% to 2.0%) to 0.9% (95% CI 0.8% to 1.1%).Incidence of culture-positive EOS, NICU admission rates and safety outcomes remained unchanged.
conclusionSPE reduced antibiotic exposure in infants ≥34 weeks' gestation without compromising safety.
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