Antibiotics (Sep 2023)

Procalcitonin-Based Antibiotic Use for Neonatal Early-Onset Bacterial Infections: Pre- and Post-Intervention Clinical Study

  • Hidetoshi Go,
  • Nobuhiko Nagano,
  • Yuki Sato,
  • Daichi Katayama,
  • Koichiro Hara,
  • Takuya Akimoto,
  • Takayuki Imaizumi,
  • Ryoji Aoki,
  • Midori Hijikata,
  • Ayako Seimiya,
  • Aya Okahashi,
  • Ichiro Morioka

DOI
https://doi.org/10.3390/antibiotics12091426
Journal volume & issue
Vol. 12, no. 9
p. 1426

Abstract

Read online

We previously reported the 95th percentile cutoff value of the serum procalcitonin (PCT) reference curve for diagnosing early-onset bacterial infection. We aimed to verify the effectivity of these novel diagnostic criteria by comparing antibiotic use and incidence of early-onset bacterial infection between pre- and post-introduction periods. We included newborns admitted to our neonatal intensive care unit who underwent blood tests within 72 h after birth between 2018 and 2022. The neonates were divided into the pre-intervention (admitted before the introduction, n = 737) or post-intervention (admitted after the introduction, n = 686) group. The days of antibiotics therapy (DOT) per 1000 patient days up to 6 days after birth, percentage of antibiotic use, and incidence of early-onset bacterial infection were compared between the groups. The post-intervention group had significantly lower DOT per 1000 patient days (82.0 days vs. 211.3 days, p p p = 0.99). In conclusion, our diagnostic criteria using the 95th percentile cutoff value of the serum PCT reference curve for early-onset bacterial infection were proven safe and effective, promoting appropriate use of antibiotics.

Keywords