PLoS Medicine (Jun 2023)

Patterns of antibiotic use, pathogens, and prediction of mortality in hospitalized neonates and young infants with sepsis: A global neonatal sepsis observational cohort study (NeoOBS).

  • Neal J Russell,
  • Wolfgang Stöhr,
  • Nishad Plakkal,
  • Aislinn Cook,
  • James A Berkley,
  • Bethou Adhisivam,
  • Ramesh Agarwal,
  • Nawshad Uddin Ahmed,
  • Manica Balasegaram,
  • Daynia Ballot,
  • Adrie Bekker,
  • Eitan Naaman Berezin,
  • Davide Bilardi,
  • Suppawat Boonkasidecha,
  • Cristina G Carvalheiro,
  • Neema Chami,
  • Suman Chaurasia,
  • Sara Chiurchiu,
  • Viviane Rinaldi Favarin Colas,
  • Simon Cousens,
  • Tim R Cressey,
  • Ana Carolina Dantas de Assis,
  • Tran Minh Dien,
  • Yijun Ding,
  • Nguyen Trong Dung,
  • Han Dong,
  • Angela Dramowski,
  • Madhusudhan Ds,
  • Ajay Dudeja,
  • Jinxing Feng,
  • Youri Glupczynski,
  • Srishti Goel,
  • Herman Goossens,
  • Doan Thi Huong Hao,
  • Mahmudul Islam Khan,
  • Tatiana Munera Huertas,
  • Mohammad Shahidul Islam,
  • Daniel Jarovsky,
  • Nathalie Khavessian,
  • Meera Khorana,
  • Angeliki Kontou,
  • Tomislav Kostyanev,
  • Premsak Laoyookhon,
  • Sorasak Lochindarat,
  • Mattias Larsson,
  • Maia De Luca,
  • Surbhi Malhotra-Kumar,
  • Nivedita Mondal,
  • Nitu Mundhra,
  • Philippa Musoke,
  • Marisa M Mussi-Pinhata,
  • Ruchi Nanavati,
  • Firdose Nakwa,
  • Sushma Nangia,
  • Jolly Nankunda,
  • Alessandra Nardone,
  • Borna Nyaoke,
  • Christina W Obiero,
  • Maxensia Owor,
  • Wang Ping,
  • Kanchana Preedisripipat,
  • Shamim Qazi,
  • Lifeng Qi,
  • Tanusha Ramdin,
  • Amy Riddell,
  • Lorenza Romani,
  • Praewpan Roysuwan,
  • Robin Saggers,
  • Emmanuel Roilides,
  • Samir K Saha,
  • Kosmas Sarafidis,
  • Valerie Tusubira,
  • Reenu Thomas,
  • Sithembiso Velaphi,
  • Tuba Vilken,
  • Xiaojiao Wang,
  • Yajuan Wang,
  • Yonghong Yang,
  • Liu Zunjie,
  • Sally Ellis,
  • Julia A Bielicki,
  • A Sarah Walker,
  • Paul T Heath,
  • Mike Sharland

DOI
https://doi.org/10.1371/journal.pmed.1004179
Journal volume & issue
Vol. 20, no. 6
p. e1004179

Abstract

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BackgroundThere is limited data on antibiotic treatment in hospitalized neonates in low- and middle-income countries (LMICs). We aimed to describe patterns of antibiotic use, pathogens, and clinical outcomes, and to develop a severity score predicting mortality in neonatal sepsis to inform future clinical trial design.Methods and findingsHospitalized infants ConclusionAntibiotic regimens used in neonatal sepsis commonly diverge from WHO guidelines, and trials of novel empiric regimens are urgently needed in the context of increasing antimicrobial resistance (AMR). The baseline NeoSep Severity Score identifies high mortality risk criteria for trial entry, while the NeoSep Recovery Score can help guide decisions on regimen change. NeoOBS data informed the NeoSep1 antibiotic trial (ISRCTN48721236), which aims to identify novel first- and second-line empiric antibiotic regimens for neonatal sepsis.Trial registrationClinicalTrials.gov, (NCT03721302).