Observational studyBMC infectious diseases2025
Outcomes and antimicrobial usage in preterm neonates < 34 weeks gestation with culture-negative neonatal sepsis: a prospective observational study.
Observational study in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Evolution of Antimicrobial Resistance in Neonatal Sepsis: A Narrative Review.Antibiotics (Basel, Switzerland) · 2026Review
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCulture-negative sepsis (CNNS) constitutes a significant proportion of neonates admitted to the NICU. However, the outcomes and factors influencing antimicrobial therapy in this group remain understudied.
methodsWe prospectively enrolled preterm neonates (<34 weeks' gestation) with clinical features of sepsis, with or without sepsis screen positive results. Primary outcome was a composite of death, bronchopulmonary dysplasia (BPD), retinopathy of prematurity requiring treatment, Intraventricular haemorrhage ≥ 2 and periventricular leukomalacia. Details of antimicrobial therapy were also collected.
resultsOver an 18-month period, 172 neonates were enrolled. 104 had CNNS and 68 had culture-positive sepsis (CPNS). Primary outcome was observed in 19 (18.3%) neonates with CNNS and 25 (36.8%) with CPNS, with an adjusted odds ratio (aOR) of 0.50 (95% CI: 0.22-1.12, p = 0.095). Except for BPD, which was significantly lower in CNNS (aOR: 0.10; 95% CI: 0.02-0.52, p = 0.006), there was no statistically significant difference in other outcomes between groups. Multidrug-resistant organisms comprised 67.6% of the gram-negative bacterial isolates. Median (IQR) cumulative duration of antibiotic therapy was 5 (3-7) days in CNNS and 20.5 (15-24.3) days in CPNS. Prolonged cumulative antibiotic use was observed in 50 (48%) CNNS neonates (>5 days) and 50 (73.5%) CPNS neonates (>14 days). In CNNS group, 38 (36.5%) received second-line antibiotics, and 6 (5.7%) received third-line antibiotics.
conclusionIn preterm neonates, composite outcome of mortality and major morbidities did not differ significantly between those with CNNS and CPNS. However, a considerable proportion of CNNS neonates received a prolonged course of higher antibiotics. Thus, there is a need for strategies to improve clinical outcomes and strengthen adherence to antibiotic stewardship principles.
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