A Neonatal Unit Experience with Empiric Antibiotics for Late-onset Neonatal Sepsis: A Retrospective Study.

UNLABELLED

Neonatal sepsis remains a major cause of morbidity and mortality and warrants the immediate start of appropriate empiric treatment. Thus, this study compared the effectiveness of the 2 antibiotic regimens (cloxacillin-amikacin or cefotaxime-ampicillin) among neonates with late-onset neonatal sepsis.

METHODS

We conducted a retrospective cohort study comparing mortality between 2 treatment cohorts of very low birth weight neonates with late-onset sepsis, who had received amikacin-cloxacillin or cefotaxime-ampicillin between January 2014 and December 2017. There were 27 neonates in each treatment arm after 1:1 propensity score matching. Univariate analyses (Chi-square and independent tests, where appropriate) were performed to determine the association between variables. We determined the hazard ratio for all-cause mortality using the Cox regression model.

RESULTS

We identified a total of 132 neonates from the hospital's record. We included 27 neonates each in the amikacin-cloxacillin and cefotaxime-ampicillin groups. Intraventricular hemorrhage, necrotizing enterocolitis, birth weight, and gestational age were significantly associated with mortality ( < 0.05). The risk of mortality was significantly higher in neonates receiving empiric cefotaxime and ampicillin than those receiving amikacin and cloxacillin (hazard ratio: 2.91, 95% confidence interval: 1.17-7.30, = 0.023).

CONCLUSIONS

In our center, amikacin-cloxacillin combination therapy was associated with lower mortality in very low birth weight neonates with late-onset sepsis compared with cefotaxime-ampicillin therapy.