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Antibiotics for Early-Onset Neonatal Infection

Antibiotics for the Prevention and Treatment of Early-Onset Neonatal Infection

NICE Clinical Guidelines, No. 149

National Collaborating Centre for Women's and Children's Health (UK).

London: RCOG Press; 2012 Aug.
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Excerpt

Early-onset neonatal bacterial infection (infection with onset within 72 hours of birth) is a significant cause of mortality and morbidity in newborn babies. Parent organisations and the scientific literature report that there can be unnecessary delays in recognising and treating sick babies. In addition, concern about the possibility of early-onset neonatal infection is common. This concern is an important influence on the care given to pregnant women and newborn babies. There is wide variation in how the risk of early-onset neonatal infection is managed in healthy babies. The approach taken by the NHS needs to: prioritise the treatment of sick babies, minimise the impact of management pathways on healthy women and babies, use antibiotics wisely to avoid the development of resistance to antibiotics. These drivers have not always been addressed consistently in the NHS, and this guideline was commissioned to ensure they would be addressed in future.

Five key principles underpin the recommendations in this guideline. Unless it is dangerous, families should be offered choice. The guideline includes recommendations to support families in making choices through provision of information and, where appropriate, reassurance. Intrapartum antibiotic prophylaxis should be administered in a timely manner to all eligible women who choose it. Babies with suspected early-onset neonatal infection should be treated as quickly as possible. Antibiotic exposure should be minimised in babies who do not have an early-onset neonatal infection. An integrated system of clinical care is needed to allow full implementation of the guideline recommendations.

Contents

While every effort has been made to ensure the accuracy of the information contained within this publication, the publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check current indications and accuracy by consulting other pharmaceutical literature and following the guidelines laid down by the manufacturers of specific products and the relevant authorities in the country in which they are practising.

This guideline has been fully funded by NICE. Healthcare professionals are expected to take it fully into account when exercising their clinical judgement. However, the guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient.

Implementation of this guidance is the responsibility of local commissioners and/or providers.

Copyright © 2012, National Collaborating Centre for Women’s and Children’s Health.

No part of this publication may be reproduced, stored or transmitted in any form or by any means, without the prior written permission of the publisher or, in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency in the UK. Enquiries concerning reproduction outside the terms stated here should be sent to the publisher at the UK address printed on this page.

The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore for general use.

PMID: 23346609

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