Shorter antibiotic courses effective for newborn infections: Lancet study with lead author from PGI

What the study did

Researchers systematically reviewed and statistically combined data from research studies comparing different antibiotic durations for serious newborn infections. Using statistically rigorous techniques, including some novel methods, the team evaluated shorter antibiotic courses against standard longer courses. Certain blood tests give a clue to the presence of infection, and they are called ‘biomarkers.’ The authors also evaluated strategies dependent on the normalisation of these blood tests, which could tailor the duration of antibiotics.

Key findings

— Proven blood infection in newborn babies: Seven days of antibiotics may be sufficient for most cases, instead of the traditionally recommended 10–14 days, without added risk.

— Treatment guided by normalisation of blood tests: Stopping treatment when ‘biomarker’ blood tests turn negative typically yields shorter courses that are adequate for many newborn infections.

— Probable infections: Evidence comparing three-four days vs five-seven days was equivocal, highlighting the need for further research studies.

— Gaps in evidence: There was insufficient data to draw firm conclusions for urinary infection, meningitis, and fungal infections. Thus, these are priority areas for future research.

Implications

It is possible to use shorter antibiotic courses for proven blood infections in newborn babies or use courses guided by normalisation of blood tests, without any added risks. If the use of shorter courses in appropriate cases is widely adopted, it could help combat antibiotic resistance, limit hospital-acquired infections, and improve resource use, especially in high-burden settings. Funding agencies should prioritise future studies in the identified evidence gaps.