C-reactive protein-guided antibiotic treatment strategy for neonates with suspected early-onset sepsis
HE Yun-Yan, CHEN Feng, ZHANG Yu, XIANG Ling-Ling, LIU Yi-Xi, HUA Zi-Yu
Department of Neonatology, Children's Hospital of Chongqing Medical University/Ministry of Education Key Laboratory of Child Development and Disorders/National Clinical Research Center for Child Health and Disorders/China International Science and Technology Cooperation Base of Child Development and Critical Disorders//Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
Abstract Objective To evaluate the efficacy and safety of C-reactive protein (CRP)-guided antibiotic treatment strategy for neonates with suspected early-onset sepsis (EOS). Methods A total of 428 neonates, with a gestational age of > 35 weeks, who were admitted to the Children's Hospital of Chongqing Medical University from February to July, 2019 and were suspected of EOS were enrolled as the observation group. The effect of antibiotic treatment was prospectively observed, and if clinical symptoms were improved and CRP was < 10 mg/L in two consecutive tests, discontinuation of antibiotics was considered. A total of 328 neonates (gestational age of > 35 weeks) who were admitted to this hospital from February to July, 2018 and were suspected of EOS were enrolled as the control group, and the use of antibiotics was analyzed retrospectively. The two groups were compared in terms of duration of antibiotic treatment, length of hospital stay, incidence rate of repeated infection and clinical outcome. Results Compared with the control group, the observation group had significantly shorter duration of antibiotic treatment and length of hospital stay (P < 0.05). There were no significant differences in the incidence rate of repeated infection and clinical outcome between the two groups (P > 0.05). Conclusions For neonates with a gestational age of > 35 weeks and a suspected diagnosis of EOS, CRP-guided antibiotic treatment strategy can shorten duration of antibiotic treatment and length of hospital stay and does not increase the incidence rate of repeated infection. Therefore, it holds promise for clinical application.
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