Clinical Evaluation of Antibiotic Therapies for Neonatal Septicemia in NICU in a Tertiary Care Setting: A Prospective Observational Study

Background

Neonatal septicemia is a major cause of neonatal mortality, often affecting infants from the first day of life. Given the underdeveloped neonatal immune system, antibiotics must be prescribed judiciously. Timely and tailored care is essential for infants showing signs of inflammation and septicemia.

Aim and Objectives

This study aims to evaluate the clinical response of neonates with septicemia to antibiotic treatment, aiming to enhance knowledge in this area and promote the improvement of antimicrobial prescribing practices. The research seeks to identify trends related to the causes, clinical course, and antibiotic treatments for neonatal septicemia.

Materials and Methods

A cross-sectional, prospective observational study with 58 pediatric patients diagnosed with neonatal septicemia was conducted at Dhiraj Hospital, Vadodara. Patients categorized as suspected or proven sepsis were included. Antibiotics were prescribed based on symptoms progression. CRP levels at diagnosis, post-treatment levels, and time to decrease levels were recorded. Statistical analysis included Excel, Social Science Statistics, and Chi-tests to calculate means, standard deviations, and derive results.

Results

The study explored factors impacting the clinical course of neonatal septicemia, such as Early-Onset Sepsis (EOS) and Late-Onset Sepsis (LOS) risk factors, the prevalence of causative pathogens, and a comparative analysis of six antibiotic groups. Among them, Group 4 (Meropenem, Vancomycin, and Colistin) showed the highest ratio of average difference in C-reactive protein levels to average days to outcome compared to other groups.

Conclusion

The findings of this research can elucidate the complex relationships among factors influencing the clinical advancement of neonatal septicemia. This information is valuable for establishing standardized protocols and enhancing antibiotic prescribing practices in neonatal care through initiatives such as antibiotic stewardship.