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

Research output: Contribution to journalArticlepeer-review

Abstract

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 < 0.01) and percentage of newborns receiving antibiotics compared with the pre-intervention group (79 (12%) vs. 280 (38%), respectively, p < 0.01). The incidence of early-onset bacterial infections did not differ between the groups (2% each, 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.

Original languageEnglish
Article number1426
JournalAntibiotics
Volume12
Issue number9
DOIs
Publication statusPublished - Sept 2023

Keywords

  • antibiotic resistance
  • antibiotics
  • appropriate use of antibiotics
  • days of antibiotic therapy
  • early-onset bacterial infection
  • procalcitonin

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