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New study finds no clear benefit from shorter antibiotic treatment in babies with sepsis

Published: 29 November 2021


Led by researchers at St George’s, University of London, the results of an international trial, published in The Lancet Child & Adolescent Health, show no clear benefit of using a shorter course of the antibiotic, vancomycin, to treat babies with sepsis occurring in hospital, also known as late onset sepsis.

The NeoVanc trial was a European, multicentre research study coordinated by Penta (an international independent research network dedicated to scientific research in favour of children’s health) and funded by the European Commission’s 7th Framework Programme.

It compared the efficacy and safety of an optimised shorter course of treatment with a standard course of vancomycin in infants with late onset sepsis.  NeoVanc took place between March 2017 and July 2019 and involved 242 infants from 22 neonatal intensive care units in Italy, Greece, Estonia, Spain and the UK.  The aim of the study was to compare recovery from sepsis as well as relapses or new infections requiring further treatment between the two groups.

The results showed there was no clear benefit from the five-day course, compared to the longer ten-day course. Babies in the short course group were more commonly assessed as not fully recovered by the end of treatment as compared with babies in the long course group

The researchers also found that twice as many babies (30%) in the short course group failed routine hearing testing compared to the longer course (15%), pointing towards potentially improved outcomes with the longer standard course.

Dr Louise Hill, Lecturer in Paediatric Infectious Diseases at St George’s, University of London, said: “Neonatal sepsis is a global health priority with around three million cases per year worldwide.  Premature babies and infants in the first three months of life represent a particularly vulnerable group because their immune systems are not yet fully developed.  In Europe, coagulase-negative staphylococci are the most frequently identified bacteria in neonatal late onset sepsis and vancomycin is the antibiotic most commonly used to treat them. However, despite being used for over 50 years, there are very few studies comparing different dosing regimens of vancomycin.”

According to the Chief Investigator, Professor Mike Sharland of the Paediatric Infectious Diseases Research Group at St George’s, University of London: “The results of the study show that there is no clear advantage for adopting a shorter five-day course, with a loading dose, over the standard ten-day course in infants under three months of age with severe sepsis.

“A NeoVanc follow-up study is planned to collect long-term hearing data on those infants who were affected by hearing dysfunction, particularly in relation to the use of the shorter treatment course.”  

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