{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T18:08:51Z","timestamp":1784311731128,"version":"3.55.0"},"reference-count":45,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2017,4,19]],"date-time":"2017-04-19T00:00:00Z","timestamp":1492560000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>Neonatal sepsis remains an important cause of morbidity and mortality, and requires prompt empiric treatment. However, only a minority of babies who receive antibiotics for suspected sepsis have an infection. Antimicrobial exposure in infancy has important short\u2010 and long\u2010term consequences. There is no consensus regarding empirical antimicrobial regimens.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study included a survey of empiric antimicrobial regimens in all tertiary neonatal intensive care units in Australia and New Zealand in 2013\u20132014.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All 27 units responded. For early\u2010onset sepsis, all units used a combination of gentamicin with either penicillin or ampicillin. For late\u2010onset sepsis, the frequency of units using empiric vancomycin (41%) versus empiric flucloxacillin (48%) was similar. Gestational age or the presence of a central venous catheter had little influence on using vancomycin instead of flucloxacillin. For late\u2010onset sepsis with meningitis there was marked variation in antimicrobial combinations, with 15 different regimens described. A total of 93% used a cefotaxime\u2010based regimen, either as monotherapy (22%) or combined with a second (22%) or third (48%) agent. For suspected necrotising enterocolitis, 89% used an aminoglycoside, metronidazole and a penicillin. Historical outbreaks of multi\u2010resistant organisms exerted long\u2010term influence over regimen choice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There was limited use of broad\u2010spectrum agents such as carbapenems or third\u2010generation cephalosporins. In this region with low methicillin\u2010resistant <jats:italic>Staphylococcus aureus<\/jats:italic> prevalence, empiric vancomycin use was common, selected for activity against coagulase\u2010negative staphylococci. Empiric vancomycin is rarely necessary because coagulase\u2010negative staphylococci are often contaminants and sepsis is rarely fulminant, occurring almost exclusively in extremely low birthweight infants. Implementation of appropriate, local antimicrobial policies is crucial to minimise antimicrobial exposure in this vulnerable population and halt the development of antimicrobial resistance.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.13540","type":"journal-article","created":{"date-parts":[[2017,4,19]],"date-time":"2017-04-19T07:19:07Z","timestamp":1492586347000},"page":"680-684","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Empiric antibiotic regimens for neonatal sepsis in Australian and New Zealand neonatal intensive care units"],"prefix":"10.1111","volume":"53","author":[{"given":"Jeremy P","family":"Carr","sequence":"first","affiliation":[{"name":"Department of Infection and Immunity Monash Children's Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David P","family":"Burgner","sequence":"additional","affiliation":[{"name":"Department of Infection and Immunity Monash Children's Hospital  Melbourne Victoria Australia"},{"name":"Department of Paediatrics, School of Clinical Sciences Monash University  Melbourne Victoria Australia"},{"name":"Murdoch Childrens Research Institute  Melbourne Victoria Australia"},{"name":"Department of Paediatrics University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohan S","family":"Hardikar","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, School of Clinical Sciences Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jim P","family":"Buttery","sequence":"additional","affiliation":[{"name":"Department of Infection and Immunity Monash Children's Hospital  Melbourne Victoria Australia"},{"name":"Department of Paediatrics, School of Clinical Sciences Monash University  Melbourne Victoria Australia"},{"name":"Murdoch Childrens Research Institute  Melbourne Victoria Australia"},{"name":"Department of Paediatrics University of Melbourne  Melbourne Victoria Australia"},{"name":"The Ritchie Centre Hudson Institute of Medical Research  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,4,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.12715"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.106.2.256"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-3423"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2011.05.033"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)90015-1"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-3407"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/2049-2618-2-38"},{"key":"e_1_2_9_9_1","first-page":"CD004501","article-title":"Antibiotic regimens for suspected late onset sepsis in newborn infants","volume":"3","author":"Gordon A","year":"2005","journal-title":"Cochrane Database Syst. 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