Antibiotic Therapy in Neonatal Sepsis
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 10
Abstract
A lot of bias exists in the management of suspected sepsis owing to the non-specific manifestations of sepsis in neonates resulting in injudicious use of antibiotics thereby increasing the risk of emergence of antibiotic resistance. Sepsis markers can help in detecting and managing sepsis more accurately. This study was conducted from June 2016 to June 2017 in the department of paediatrics in Gandhi Hospital, to determine whether normalization of CRP correlates with recovery from sepsis aiding the decision about the duration of antibiotic therapy .110 neonates with sepsis were studied prospectively. .A value of > 6 mg/L of CRP was taken as indicative of sepsis. If it was < 6mg/L antibiotics were stopped and patients were assigned to group 1.Neonates with CRP > 6mg/L were assigned to group 2 and are randomized into group 2A in which antibiotics were discontinued after 7 days if the CRP was negative and 2 B in which antibiotics were stopped as soon as CRP turned negative. All the babies were followed up for relapse for four weeks. CRP was negative on first estimation in 26 cases (23.6%) and antibiotics were stopped (Group 1). No relapse was observed. In the remaining 84(76.4%) cases, Group2, all the cases with positive blood culture were given standard therapy and were not followed up with serial CRP measurements. Fifteen babies from group 2 received antibiotics for seven days and antibiotics were stopped when CRP was found to be negative on 7th day (2A).Therapy was stopped based on negative CRP value on or before 7 days in 18 cases in group 2B. In group 2B, mean duration of treatment was 5.3 ± 1.1 days when compared to group 2A where it was 7 ± 1 days. No relapses were noted in both the groups. There is 100% negative predictive value of serial CRP measurement. This has implication in reducing the cost of therapy, duration of hospitalization and reducing the emergence of antimicrobial resistance.
Authors and Affiliations
A. Soumya, N. Srinivasa Suresh
Keywords
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