Indian Study Finds Shorter Antibiotic Courses Effective for Newborns

A team of Indian neonatologists (i.e., newborn specialist doctors), including Dr Saikiran D, a Consultant Neonatologist at Fernandez Hospital, has published an important study in the UK-based journal, Lancet Clinical Medicine, which shows that shorter antibiotic courses are often as effective as traditional longer courses for common serious newborn infections.

Antibiotics save lives, but using them too often or too long can cause antibiotic resistance that makes infections harder to treat. It also exposes vulnerable newborns to side effects, longer hospital stays, and higher costs. Premature and sick newborns receive antibiotics more frequently and for longer periods than older children and adults. Doctors have long suspected that shorter antibiotic courses may be sufficient in many cases, but strong and credible evidence has been limited — until now.

During this study, researchers systematically reviewed and statistically combined data comparing different antibiotic durations for serious newborn infections. The authors also studied strategies that depend on “biomarkers”, which will help doctors to see if an infection is reducing and decide if they can stop the antibiotic course. Certain blood tests indicate the presence of infection, and these clues are called “biomarkers”.

Key findings of this important study

• About 7 days of antibiotics may be enough in most cases, instead of the usually recommended 10–14 days, without added risk.
• Stopping treatment when the “biomarker” blood tests turn negative typically leads to shorter antibiotic courses that are effective and adequate for many newborn infections.
• Evidence comparing antibiotic courses of 3–4 days vs 5–7 days was unclear, highlighting the need for further research studies.
• There were insufficient data to draw firm conclusions for urinary infection, meningitis, and fungal infections. Thus, these are priority areas for future research.

It is possible to safely use shorter antibiotic courses for proven blood infections in newborns, and if widely adopted, it could help fight antibiotic resistance, reduce hospital infections, and improve resource use, especially in hospital settings that have patient overload or limited facilities.