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It is time to standardise the length of postnatal antibiotic administration nationally
  1. Michael Malley1,
  2. Marnie Bruce1,
  3. Hannah Devlin1,
  4. Harsita Patel1,
  5. Dheeraj Narendra2,
  6. Seth Cox2,
  7. Ravi Chotalia2
  1. 1 Department of Paediatrics, West Middlesex Hospital, London, UK
  2. 2 Medical School, Imperial College Medical School, London, UK
  1. Correspondence to Dr Michael Malley, Department of Paediatrics, West Middlesex Hospital, London TW76AF, UK; m.malley{at}

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The National Institute for Health and Care Excellence (NICE) guidelines recommend intravenous antibiotics to be discontinued at 36 hours in asymptomatic, low-risk babies with negative blood cultures and reassuring inflammatory markers.1 Despite this, national practice remains varied.

On contacting all 155 neonatal units in England, 91 units reported using a 36-hour blood culture threshold. Fifty-nine (38%) units reported awaiting 48-hour cultures, with 235 972 babies born in these units in 2016–2017.2 A further five units awaited 24-hour cultures (table 1).

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Table 1

National variation in time to stop antibiotics in low-risk, asymptomatic babies with reassuring inflammatory markers and negative culture results

The barriers to 36-hour culture results may be varied, often involving transport to central laboratories and access to reporting/analysing systems.3 However, stopping antibiotics at 36 hours could …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data sharing statement A spreadsheet of data collection exists and is available to the authors only. This includes records of CRP measurements and blood culture results for cases of suspected neonatal sepsis at the local hospital.