Reducing Antibiotic Exposure in Suspected Neonatal Sepsis

Christopher Henry Grant, Andrew Arnott, Tim Brook, Alice Horne, William Hurst, Sarah Kelly, Christina Lang, Madeleine Payne, Hannah Pert, Sarah Sparrow, Pakaye Anne Dokubo, Natalie Bee, Ruth Gibbs, Julie-Clare Becher (Lead / Corresponding author)

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


Prolonged antibiotic therapy is associated with antimicrobial resistance and increased mortality in preterm infants. We evaluated the impact of an automatic stop order (ASO) and C-reactive protein (CRP) on the duration of antibiotics and level of intervention in infants screened for early-onset sepsis who had negative cultures. We introduced an ASO for low-risk infants, then, consequently, for all infants treated for suspected sepsis. We subsequently introduced a single CRP measurement at 36 hours. Between 2011 and 2014, 4 time periods were studied, at baseline and after each intervention. The proportion of infants receiving ≤48 hours of antibiotics increased from 19% to 72.5% (P <.0001), whereas that of infants receiving avoidable doses (>48 hours and <5 days) fell from 50% to 0.8% (P <.0001). The use of an ASO decreased the proportion receiving avoidable doses from 26/92 (28.3%) to 9/293 (3.1%); P <.0001. There was a reduction in lumbar punctures performed, from 35% to 20%; P =.015.

Original languageEnglish
Pages (from-to)76-81
Number of pages6
JournalClinical Pediatrics
Issue number1
Publication statusPublished - 1 Jan 2018


  • audit
  • intensive care
  • neonatology
  • pharmacology
  • therapeutics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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