Journal
ACTA PAEDIATRICA
Volume -, Issue -, Pages -Publisher
WILEY
DOI: 10.1111/apa.16972
Keywords
anti-bacterial agents; blood culture; neonatal sepsis; newborn; systematic review
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This study aimed to evaluate the efficacy and harms of a short duration (7-10 days) compared with a standard duration (10-14 days) of antibiotics in treating culture-proven neonatal sepsis. The study included five trials conducted in India and found that the short-term antibiotics regimen may shorten the duration of hospitalisation by 4 days, but evidence for other outcomes was very uncertain.
Aim To evaluate the efficacy and harms of a short (7-10 days) compared with a standard (10-14 days) duration of antibiotics in culture-proven neonatal sepsis for reducing all-cause mortality, treatment failure and duration of hospitalisation.Methods Medline, EMBASE and Cochrane CENTRAL were searched for randomised trials.Results We included five studies, all conducted in India (447 infants with a gestational age greater than 32 weeks). Except for one study, all studies were at high risk of bias. All-cause mortality was reported in three studies with only one death reported in the standard duration regimen arm (243 patients, very low certainty). A meta-analysis showed no evidence of the effect on treatment failure (RR of 1.47 [95% CI 0.48-4.50], 440 patients, five studies, very low certainty) of short-term antibiotics. Short-term antibiotic regimen shortened the duration of hospitalisation by 4 days (mean difference of -4.04 days [95% CI -5.47 to -2.61]; 4 studies; 371 patients; very low certainty).Conclusion Among studies focused on infants born with a gestational age greater than 32 weeks, short-term administration of antibiotics may shorten the duration of hospitalisation, but the evidence is very uncertain. The evidence on other predefined outcomes is very uncertain to draw definite conclusions.
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