Incidence of Antibiotic Exposure for Suspected and Proven Neonatal Early-Onset Sepsis between 2019 and 2021: A Retrospective, Multicentre Study
Liesanne E. J. van Veen,
Bo M. van der Weijden,
Niek B. Achten,
Lotte van der Lee,
Jeroen Hol,
Maaike C. van Rossem,
Maarten Rijpert,
Anna O. J. Oorthuys,
Ron H. T. van Beek,
Gerdien H. Dubbink-Verheij,
René F. Kornelisse,
Laura H. van der Meer-Kapelle,
Karen Van Mechelen,
Suzanne Broekhuizen,
A. Carin M. Dassel,
J. W. F. M. Corrie Jacobs,
Paul W. T. van Rijssel,
Gerdien A. Tramper-Stranders,
Annemarie M. C. van Rossum,
Frans B. Plötz
Affiliations
Liesanne E. J. van Veen
Department of Paediatrics, Franciscus Gasthuis en Vlietland, Kleiweg 500, 3045 PM Rotterdam, The Netherlands
Bo M. van der Weijden
Department of Paediatrics, Tergooi MC, Laan van Tergooi 2, 1212 VG Hilversum, The Netherlands
Niek B. Achten
Department of Paediatrics, Erasmus MC University Medical Center, Sophia Children’s Hospital, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
Lotte van der Lee
Department of Paediatrics, Amsterdam UMC, Emma Children’s Hospital, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
Jeroen Hol
Department of Paediatrics, Noordwest Hospital, Wilhelminalaan 12, 1815 JD Alkmaar, The Netherlands
Maaike C. van Rossem
Department of Paediatrics, Rijnstate Hospital, Wagnerlaan 55, 6815 AD Arnhem, The Netherlands
Maarten Rijpert
Department of Paediatrics, Zaans Medical Centre, Kon. Julianaplein 58, 1502 DV Zaandam, The Netherlands
Anna O. J. Oorthuys
Department of Paediatrics, Amsterdam UMC, Emma Children’s Hospital, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
Ron H. T. van Beek
Department of Paediatrics, Amphia Hospital, Molengracht 21, 4818 CK Breda, The Netherlands
Gerdien H. Dubbink-Verheij
Department of Paediatrics, Groene Hart Hospital, Bleulandweg 10, 2803 HH Gouda, The Netherlands
René F. Kornelisse
Department of Neonatal and Paediatric Intensive Care, Division of Neonatology, Erasmus MC University Medical Center, Sophia Children’s Hospital, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
Laura H. van der Meer-Kapelle
Department of Paediatrics, Reinier de Graaf Gasthuis, Reinier de Graafweg 5, 2625 AD Delft, The Netherlands
Karen Van Mechelen
Department of Neonatology, Maastricht University Medical Center (MUMC+), MosaKids Children’s Hospital, 6229 HX Maastricht, The Netherlands
Suzanne Broekhuizen
Department of Paediatrics, Wilhelmina Hospital Assen, Europaweg-Zuid 1, 9400 RA Assen, The Netherlands
A. Carin M. Dassel
Department of Paediatrics, Deventer Hospital, Nico Bolkesteinlaan 75, 7416 SE Deventer, The Netherlands
J. W. F. M. Corrie Jacobs
Department of Paediatrics, Jeroen Bosch Hospital, Henri Dunantstraat 1, 5223 GZ Hertogenbosch, The Netherlands
Paul W. T. van Rijssel
Department of Paediatrics, Maaziekenhuis Pantein, Dokter Kopstraat 1, 5835 DV Beugen, The Netherlands
Gerdien A. Tramper-Stranders
Department of Paediatrics, Franciscus Gasthuis en Vlietland, Kleiweg 500, 3045 PM Rotterdam, The Netherlands
Annemarie M. C. van Rossum
Department of Paediatrics, Erasmus MC University Medical Center, Sophia Children’s Hospital, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
Frans B. Plötz
Department of Paediatrics, Tergooi MC, Laan van Tergooi 2, 1212 VG Hilversum, The Netherlands
Management of suspected early-onset sepsis (EOS) is undergoing continuous evolution aiming to limit antibiotic overtreatment, yet current data on the level of overtreatment are only available for a select number of countries. This study aimed to determine antibiotic initiation and continuation rates for suspected EOS, along with the incidence of culture-proven EOS in The Netherlands. In this retrospective study from 2019 to 2021, data were collected from 15 Dutch hospitals, comprising 13 regional hospitals equipped with Level I-II facilities and 2 academic hospitals equipped with Level IV facilities. Data included birth rates, number of neonates started on antibiotics for suspected EOS, number of neonates that continued treatment beyond 48 h and number of neonates with culture-proven EOS. Additionally, blood culture results were documented. Data were analysed both collectively and separately for regional and academic hospitals. A total of 103,492 live-born neonates were included. In 4755 neonates (4.6%, 95% CI 4.5–4.7), antibiotic therapy was started for suspected EOS, and in 2399 neonates (2.3%, 95% CI 2.2–2.4), antibiotic treatment was continued beyond 48 h. Incidence of culture-proven EOS was 1.1 cases per 1000 live births (0.11%, 95% CI 0.09–0.14). Overall, for each culture-proven EOS case, 40.6 neonates were started on antibiotics and in 21.7 neonates therapy was continued. Large variations in treatment rates were observed across all hospitals, with the number of neonates initiated and continued on antibiotics per culture-proven EOS case varying from 4 to 90 and from 4 to 56, respectively. The high number of antibiotic prescriptions compared to the EOS incidence and wide variety in clinical practice among hospitals in The Netherlands underscore both the need and potential for a novel approach to the management of neonates with suspected EOS.
