Newborn sepsis deaths linked to ineffective antibiotics
July/August 2023 | Volume 22 Number 4
Photo courtesy of USAID/Adey Abebe
A woman, her husband, and her healthy baby in the Oromia Region of Ethiopia. A recent study found no single accepted “standard of care” for neonatal sepsis in LMIC hospitals.
Every year more than 200,000 newborns die of sepsis, the life-threatening bloodstream infection that affects up to 3 million babies annually. Newborn sepsis is most often caused by bacteria: During delivery, the newborn may be exposed to an infection in the birth canal. Once born, a baby may be exposed to infections in the hospital or at home.
An observational study published in
PLOS Medicine looked at more than 3,200 newborn babies diagnosed with sepsis at 19 hospitals in 11 countries between 2018 and 2020. It found considerable variation in deaths due to sepsis—from 1.6% to 27.3%, with the highest rates seen in settings with the fewest health care resources. Hospital locations included Asia (Bangladesh, China, India, Thailand, and Vietnam), Africa (Kenya, South Africa, and Uganda), Europe (Italy and Greece), and South America (Brazil).
The study also revealed wide disparities in treatment. More than 200 different antibiotic combinations were used by the hospitals. Approximately 20% of initial regimens used to treat the babies were carbapenem-based drugs, classified by the WHO as “high watch” antibiotics (those with the greatest power against resistant bacteria) or “reserve” antibiotics (those needed to treat infections caused by multi-drug-resistant organisms. Physicians also frequently switched treatments due to resistance. Meanwhile, roughly 40% of the sepsis episodes were healthcare-associated.
“Antibiotic regimens used in neonatal sepsis commonly diverge from WHO guidelines,” concluded the co-authors (more than 80 researchers worldwide). They noted that increasing antimicrobial resistance disproportionately affects infants with sepsis in low- and middle-income countries (LMICs) and undermines the effectiveness of WHO-recommended antibiotics.
The results of the study, funded by the Global Antibiotic Research and Development Partnership, have been used to design a clinical trial to find better treatments for newborn infections in the context of increasing resistance.
More information
Updated: August 2, 2023
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