{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T21:10:11Z","timestamp":1793740211207,"version":"4.6.1"},"reference-count":36,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Appropriate use of antibiotics is life-saving in neonatal early-onset sepsis (EOS), but overuse of antibiotics is associated with antimicrobial resistance and long-term adverse outcomes. Large international studies quantifying early-life antibiotic exposure along with EOS incidence are needed to provide a basis for future interventions aimed at safely reducing neonatal antibiotic exposure.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To compare early postnatal exposure to antibiotics, incidence of EOS, and mortality among different networks in high-income countries.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This is a retrospective, cross-sectional study of late-preterm and full-term neonates born between January 1, 2014, and December 31, 2018, in 13 hospital-based or population-based networks from 11 countries in Europe and North America and Australia. The study included all infants born alive at a gestational age greater than or equal to 34 weeks in the participating networks. Data were analyzed from October 2021 to March 2022.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Exposure to antibiotics started in the first postnatal week.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The main outcomes were the proportion of late-preterm and full-term neonates receiving intravenous antibiotics, the duration of antibiotic treatment, the incidence of culture-proven EOS, and all-cause and EOS-associated mortality.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 757\u202f979 late-preterm and full-term neonates were born in the participating networks during the study period; 21\u202f703 neonates (2.86%; 95% CI, 2.83%-2.90%), including 12\u202f886 boys (59.4%) with a median (IQR) gestational age of 39 (36-40) weeks and median (IQR) birth weight of 3250 (2750-3750) g, received intravenous antibiotics during the first postnatal week. The proportion of neonates started on antibiotics ranged from 1.18% to 12.45% among networks. The median (IQR) duration of treatment was 9 (7-14) days for neonates with EOS and 4 (3-6) days for those without EOS. This led to an antibiotic exposure of 135 days per 1000 live births (range across networks, 54-491 days per 1000 live births). The incidence of EOS was 0.49 cases per 1000 live births (range, 0.18-1.45 cases per 1000 live births). EOS-associated mortality was 3.20% (12 of 375 neonates; range, 0.00%-12.00%). For each case of EOS, 58 neonates were started on antibiotics and 273 antibiotic days were administered.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n The findings of this study suggest that antibiotic exposure during the first postnatal week is disproportionate compared with the burden of EOS and that there are wide (up to 9-fold) variations internationally. This study defined a set of indicators reporting on both dimensions to facilitate benchmarking and future interventions aimed at safely reducing antibiotic exposure in early life.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2022.43691","type":"journal-article","created":{"date-parts":[[2022,11,23]],"date-time":"2022-11-23T11:34:04Z","timestamp":1669203244000},"page":"e2243691","source":"Crossref","is-referenced-by-count":96,"title":["Analysis of Antibiotic Exposure and Early-Onset Neonatal Sepsis in Europe, North America, and Australia"],"prefix":"10.1001","volume":"5","author":[{"given":"Eric","family":"Giannoni","sequence":"first","affiliation":[{"name":"Clinic of Neonatology, Department Mother-Woman-Child, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varvara","family":"Dimopoulou","sequence":"additional","affiliation":[{"name":"Clinic of Neonatology, Department 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