Infection in newborns: improving antibiotic treatment
This research was completed on 26 September 2014
Published on 22 November 2011
Infection is a major cause of death and illness in newborn babies in intensive care.1-3 Evidence suggests that one of the antibiotics that is most often given to newborns in the UK – gentamicin – is not always used properly. 4 Professor Paul Heath at St Georges, University of London, believes the lack of a convenient way of monitoring gentamicin treatment may be partly to blame. He hopes to put this right, by developing a computer program that will guide the treatment of vulnerable newborns.
What is the problem and who does it affect?
Newborn babies with suspected or proven infections need urgent treatment with an antibiotic to help save their lives and protect them from complications. Without treatment, infection can progress rapidly and prove fatal.
Infection, or the possibility of infection, is in fact so common in babies in the UK that around 12 per cent of newborns receive antibiotics.5 Gentamicin is by far the most commonly used treatment – around 15,000 babies receive gentamicin for more than five days each year in the UK.6
It is vital to get gentamicin treatment right, so that it is both safe and effective, but this is far from straightforward, as Professor Paul Heath explains: “We lack nationally agreed guidelines on the best way to treat babies with gentamicin – on how to calculate the right dose for each baby, how often to give the drug, and how to monitor levels in a baby’s body.”
Sadly, this lack of consensus can have important consequences. “If we give too little gentamicin, the baby might not get better; if we give too much, babies can suffer kidney failure or lose their hearing. Unfortunately, gentamicin is the drug that is most often linked to mistakes in treating newborn babies,” says Professor Heath.
What is the project trying to achieve?
Professor Heath and his team are developing a computer program called neoGent, which could standardise and improve the way newborn babies are treated with the antibiotic gentamicin when fighting infection.
“We hope our new program will allow doctors to calculate the best dosage regimen for each baby, taking into account factors such as their age, weight and what type of infection they have,” explains Professor Heath.
“We also hope the program will reduce the number of blood tests that babies have to endure. Currently, babies have a blood test done specifically to measure the level of gentamicin. If we can monitor gentamicin levels using blood taken during routine tests, and we are investigating this, babies would suffer less discomfort and parents less distress. It would also save nurses’ time.”
Around 170 babies are taking part in this study. The ultimate goal, after larger-scale clinical trials, is to make the program available nationwide.
What are the researchers’ credentials?
The project leader, Professor Paul Heath, is a UK expert in newborn infections and childhood vaccination. Professor Heath’s research group runs a national database, called neonIN, which gathers together information on infection in newborns. The project team consists of national experts in neonatalogy, pharmacology and paediatric infectious diseases; expertise that is perfectly suited to this study.
|Project Leader||Dr Paul Heath|
|Location||Clinical Sciences, St Georges University of London and the Paediatric Infectious Diseases Unit, St Georges Hospital|
|Grant awarded||22 August 2011|
|Start date||27 July 2012|
|End date||26 September 2014|
|Grant code||SP4650, GN1834|
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- Olsen AL et al. Nosocomial infection in a Danish Neonatal Intensive Care Unit: a prospective study. Acta Paediatr 2009; 98(8):1294-9.
- Carey AJ et al. Hospital-acquired infections in the NICU: epidemiology for the new millennium. Clin Perinatol 2008; 35(1): 223-49.
- Vergnano S et al. Neonatal infections in England: the NeonIN surveillance network. Arch Dis Child Fetal Neonatal Ed 2011; 96(1):F9-14.
- Kadambari S, Heath PT, Sharland M, Lewis S, Nicholls, A, Turner MA. Variation in gentamicin and vancomycin dosage and monitoring in UK neonatal units. Journal of Antimicrobial Chemotherapy 2011 (in press).
- Luck S, Torry M, d'Agapeyeff K, Pitt A, Heath PT, Breathnach A, Bedford Russell A. Estimated early-onset group B streptococcal neonatal disease. Lancet 2003; 361:1953-4.
- ~ 27% of babies who start gentamicin subsequently continue for at least 5 days (unpublished 12 months survey data: M. Hubbard; University Hospitals of Leicester NHS Trust).