Short-course antibiotic therapy for pneumonia in the neonatal intensive care unit

J Perinatol. 2023 Sep;43(9):1145-1151. doi: 10.1038/s41372-023-01720-6. Epub 2023 Jul 12.

Abstract

Objective: To determine the adherence and safety outcomes of a 5-day antibiotic course with a "time-out" for treatment of "blood culture-negative" pneumonia in the NICU.

Study design: Prospective surveillance of all infants diagnosed with pneumonia at 7 NICUs from 8/2020-12/2021. Safety outcomes were defined a priori by re-initiation of antibiotic therapy within 14 days after discontinuation and overall and sepsis-related mortality.

Results: 128 infants were diagnosed with 136 episodes of pneumonia; 88% (n = 119) were treated with 5 days of definitive antibiotic therapy. Antibiotics were restarted within 14 days in 22 (16%) of the 136 pneumonia episodes. However, only 3 (3%) of the 119 episodes of pneumonia treated for 5 days had antibiotics restarted for pneumonia. Mortality was 5% (7/128); 5 of the 7 deaths were assessed as sepsis-related.

Conclusion: Adherence to the 5-day definitive antibiotic treatment for "culture-negative" pneumonia was high and the intervention seemed safe.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Humans
  • Infant
  • Infant, Newborn
  • Intensive Care Units, Neonatal
  • Pneumonia* / drug therapy
  • Prospective Studies
  • Sepsis* / epidemiology

Substances

  • Anti-Bacterial Agents