Abstract
Newborns are often tested, then treated for presumptive bacterial infection. Inconclusive results may perpetuate unnecessary therapy. We studied 123 neonates prospectively evaluated for infection. Complete physical examinations including pneumatic otoscopy as well as chest radiographs were performed on all patients. Of 11 screening tests, only WBC, absolute band count, and CRP showed statistical differences (p<.05) between 32 patients with positive non-permissive (blood, CSF, suprapubic or catheter urine, needle aspirate, tracheal aspirate) cultures and 50 with negative cultures who had antibiotic therapy discontinued within 72 hours. 41 additional patients had therapy continued, despite negative cultures. Incomplete culture evaluations resulted in unconfirmed “pneumonia” in 24 of these patients. No statistical differences between the culture negative groups existed regardless of treatment status. Patients in the later group may not have required continued treatment. A complete bacteriologic work-up emphasizing non-permissive cultures should be done in newborns suspected of infection. When negative, antibiotics may be stopped. In equivocable cases, a negative CRP best supports stopping therapy. This approach can reduce the total duration of newborns' exposure to antibiotics by approximately 40%.
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Squire, E., Favara, B., Merenstein, G. et al. 1439 REDUCING DURATION OF ANTIBIOTIC USE IN NEWBORNS. Pediatr Res 15 (Suppl 4), 683 (1981). https://doi.org/10.1203/00006450-198104001-01468
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DOI: https://doi.org/10.1203/00006450-198104001-01468