{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T18:08:52Z","timestamp":1784311732059,"version":"3.55.0"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"vor","delay-in-days":43,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To survey the current antibiotic and antifungal drug practices of UK neonatal intensive care units (NICUs), and to identify antibiotic preferences and policies for treatment of early- and late-onset sepsis (EoS and LoS), meningitis, and antifungal prophylaxis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Between January and May 2024, we contacted all 53 tertiary-level UK NICUs via telephone and\/or e-mail. We requested a copy of each unit\u2019s guidelines for antibiotic treatment of EoS and LoS, and antifungal prophylaxis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We obtained guidelines from 53\/53 (100%) units. A penicillin and aminoglycoside combination was the consistent first-line recommendation for EoS in 51\/53 (96%) units. Only a minority (11\/53; 21%) units specified any second-line antibiotic regimen for EoS, though most (44\/53; 83%) specifically recommended amoxicillin for suspected listeriosis. For LoS, almost all NICUs (52\/53; 98%) provided specific guidance on empirical first-line antibiotic treatment, with empirical narrow-spectrum antibiotics as first-line LoS treatment for term neonates in 42\/53 (79%) NICUs and for preterm neonates in 41\/53 (77%) NICUs. Fifty-four percent (29\/53) of units included specific LoS recommendations for neonates with indwelling central venous catheters. Sixty-six percent (35\/53) of NICUs included cefotaxime in their empirical meningitis regimens. Eighty-five percent (45\/53) of units had clear guidelines for antifungal prophylaxis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>While EoS treatment was consistent across units, there remained wide variation in antibiotic regimens used for LoS and meningitis, and for neonates with indwelling central venous catheters. Guidelines specific to preterm neonates were limited. The practice of routine antifungal prophylaxis has been more prevalent since the last UK survey in 2006\u201307 but is still neither universal nor consistent.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jacamr\/dlaf194","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T08:01:56Z","timestamp":1760601716000},"source":"Crossref","is-referenced-by-count":1,"title":["Current antibiotic and prophylactic antifungal drug policies in UK neonatal intensive care units: a national survey"],"prefix":"10.1093","volume":"7","author":[{"given":"Carla","family":"Kantyka","sequence":"first","affiliation":[{"name":"Neonatal Intensive Care Unit, Norfolk and Norwich University Hospitals NHS Foundation Trust , Colney Lane, Norwich NR4 7UY ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rishini","family":"Wanigasekara","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Ashford and St Peter\u2019s NHS Foundation Trust , Guildford Road, Chertsey KT16 0PZ ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vennila","family":"Ponnusamy","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Ashford and St Peter\u2019s NHS Foundation Trust , Guildford Road, Chertsey KT16 0PZ ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul T","family":"Heath","sequence":"additional","affiliation":[{"name":"Vaccine Institute, Centre for Neonatal and Paediatric Infection, City St George\u2019s, University of London , Cranmer Terrace, London SW17 0RE ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6203-7632","authenticated-orcid":false,"given":"Paul","family":"Clarke","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Norfolk and Norwich University Hospitals NHS Foundation Trust , Colney Lane, Norwich NR4 7UY ,","place":["UK"]},{"name":"Norwich Medical School, University of East Anglia , Norwich NR4 7TJ ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,10,16]]},"reference":[{"key":"2025101604015255700_dlaf194-B1","author":"NICE"},{"key":"2025101604015255700_dlaf194-B2","author":"British Association of Perinatal Medicine"},{"key":"2025101604015255700_dlaf194-B3","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1016\/j.eimc.2024.07.010","article-title":"Neonatal sepsis: epidemiology and comparison between preterm and term newborns","volume":"43","author":"Rubio-Mora","year":"2025","journal-title":"Enferm Infecc Microbiol Clin (Engl Ed)"},{"key":"2025101604015255700_dlaf194-B4","doi-asserted-by":"publisher","first-page":"e2022058813","DOI":"10.1542\/peds.2022-058813","article-title":"Late-onset sepsis among very preterm infants","volume":"150","author":"Flannery","year":"2022","journal-title":"Pediatrics"},{"key":"2025101604015255700_dlaf194-B5","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1093\/jac\/dkad358","article-title":"Variation in antibiotic consumption in very preterm infants\u2014a 10-year population-based study","volume":"79","author":"Huncikova","year":"2024","journal-title":"J Antimicrob Chemother"},{"key":"2025101604015255700_dlaf194-B6","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1093\/jac\/dkx426","article-title":"Antibiotic therapy in neonates and impact on gut microbiota and antibiotic resistance development: a systematic review","volume":"73","author":"Fjalstad","year":"2018","journal-title":"J Antimicrob Chemother"},{"key":"2025101604015255700_dlaf194-B7","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1093\/jac\/dkm543","article-title":"Antimicrobial policies in neonatal units of the United Kingdom and Republic of 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