Antibiotic Use in the Neonatal Intensive Care Unit Correlates Poorly with Sepsis Incidence

Previous studies in a group of neonatal intensive care units (NICUs) in California highlight wide variability in antibiotic use (NEJM JW Pediatr Adolesc Med Oct 2018 and Pediatrics 2018; 142:e20180115). In an attempt to better understand what drives this variability, the same researchers examined rates of antibiotic exposure and proven early-onset and late-onset sepsis among over 326,000 live births in 2017 at 116 NICUs in California. They calculated sepsis diagnostic efficacy from the 102 NICUs with at least one case of proven sepsis. Findings include the following:

• Overall, 8.5% of all newborns received an antibiotic during their NICU stay (range across hospitals, 1.6%–42.5%).

• Overall, 34.3 infants were treated per proven bloodstream infect…