title: Seven versus 10 days antibiotic therapy for culture-proven neonatal sepsis: A randomised controlled trial.
abstract: OBJECTIVE
  Optimal duration of parenteral antibiotics for treating neonatal sepsis ranges from 7-14 days. We compared the efficacy of 7 versus 10 days duration of intravenous antibiotics for neonatal septicaemia.
  
  
  METHODS
  We randomised blood culture-proven septic neonates (≥32 weeks and birth weight ≥1.5 kg) to receive either 7 or 10 days duration of intravenous antibiotics. We followed up neonates upto 28 days after stopping antibiotics for treatment failure defined by reappearance of clinical sepsis with a blood culture growing the same organism as cultured earlier, or in the absence of a positive culture, the presence of C-reactive protein and as adjudicated by an expert committee.
  
  
  RESULTS
  A total of 132 neonates were randomised to receive either 7 (n = 66) or 10 (n = 66) days duration of antibiotic therapy. Out of 128 neonates (64 per group) followed up, two (one per group) were regarded as 'treatment failure', and two were labelled as fresh episodes of sepsis (both in 10-day group). The risk (95% confidence interval) for treatment failure in the 7-day group was (1.0 (0.064-15.644) was not significantly higher. Neonates in both groups had comparable need for oxygen, inotropic support and blood products, duration of oxygen therapy and time to attainment of full feeds. The duration of hospitalisation was significantly longer in the 10-day group.
  
  
  CONCLUSIONS
  A 7-day course of intravenous antibiotics may be sufficient to treat neonatal sepsis with the advantage of shorter hospital stay, but a larger meta-analysis would be required to state this with a degree of certainty.
authors.affiliation: Department of Pediatrics, University College of Medical Sciences, Delhi, India.
authors.forename: Smriti
authors.initials: S
authors.lastname: Rohatgi
authors.affiliation: Department of Pediatrics, University College of Medical Sciences, Delhi, India.
authors.forename: Pooja
authors.initials: P
authors.lastname: Dewan
authors.affiliation: Department of Pediatrics, University College of Medical Sciences, Delhi, India.
authors.forename: Mohammad Moonis Akbar
authors.initials: MMA
authors.lastname: Faridi
authors.affiliation: Department of Microbiology, University College of Medical Sciences, Delhi, India.
authors.forename: Ashwani
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Department of Biostatistics and Medical Informatics, University College of Medical Sciences, Delhi, India.
authors.forename: Rajeev Kumar
authors.initials: RK
authors.lastname: Malhotra
authors.affiliation: Department of Pediatrics, University College of Medical Sciences, Delhi, India.
authors.forename: Prerna
authors.initials: P
authors.lastname: Batra
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D000071997:Blood Culture / Q000379:methods; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D008297:Male; D008826:Microbial Sensitivity Tests; D000071074:Neonatal Sepsis / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality*; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: antibiotic; neonate; sepsis; treatment