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PLD.56 Empirical treatment of early neonatal infection and the postnatal service
  1. M Kazeem1,
  2. K Brownlie1,
  3. S Sharma1,
  4. G Ayida1,
  5. S Chuang2,
  6. E Ogundipe2,
  7. C Ji3,
  8. G Kontosorou4
  1. 1Department of Obstetrics, Chelsea and Westminster Hospital Foundation Trust, London, UK
  2. 2Department of Neonatology, Chelsea and Westminster Hospital Foundation Trust, London, UK
  3. 3Year 5 Medical Student, Imperial College, London, UK
  4. 4Department of Midwifery, Chelsea and Westminster Hospital Foundation Trust, London, UK

Abstract

Background Early onset neonatal infection is becoming an indication for neonatal stay of term babies in the postnatal ward. Interventions like intra-partum intravenous antibiotics (IV-Abs) in women with suspected chorioamnionitis and NICE guidelines on use of empirical neonatal antibiotic aim to reduce morbidity and mortality associated with early neonatal infection.1, 2

An audit was undertaken to understand the characteristics of women whose babies required empirical antibiotics on the postnatal ward in a tertiary hospital and identify measures that will minimise morbidity of early neonatal infection.

Method A prospective audit of newborns requiring prophylactic IV-Abs on the postnatal ward was coupled with a six-month retrospective prescription database review.

Results

  1. Prospective review of 47 term newborns from August–September 2013 revealed

  • 68% (n = 32) were born to primiparous women.

  • Induction of labour was required for 72% (n = 34) births.

  • 25% (n = 12) received IV-Abs in labour.

ResultsPrimips were more likely to have prolonged rupture of membranes – 50% (n = 16).

  1. Retrospective review: Noted an increase in number of neonatal prophylactic IV-Abs prescriptions from 10.7% to 13.5% from 1st January – 30th June between the years 2012 and 2013 respectively.

Conclusion Majority of babies requiring antibiotics in the early neonatal period are born to first time mums – most of whom had labour induced. Presently, 16 babies per week require empirical antibiotics. This has resulted in an increase in the length of stay of mothers fit for discharge, with a knock-on effect on bed blockage and disruption of activity flows within the maternity service.

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