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NICE criticises delays in care for newborns with infections

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Some hospitals are causing “unnecessary delays” in treating newborn babies suffering from infections, the healthcare watchdog has said.

The National Institute for Health and Clinical Excellence has published new guidance after finding variations in the treatment of babies with early-onset neonatal infection.

It found delays in hospitals recognising and treating sick babies, while many newborns were at risk of becoming resistant to treatment after “needlessly” receiving antibiotics, NICE said.

Early-onset neonatal infection - which occurs within 72 hours of birth - causes the death of one in four babies who are diagnosed, even when they are given antibiotics.

NICE’s recommendations have now urged medical staff to treat infected babies within an hour of diagnosis and use antibiotics appropriately to avoid the development of bacterial resistance to treatment.

Professor Mark Baker, director of the centre for clinical practice at NICE, said: “Early-onset neonatal infection can be very serious and, at present, there is much variation in how it is managed, with sometimes unnecessary delays in recognising and treating sick babies.

“Many babies are receiving antibiotics needlessly, and consequently there is concern that the effectiveness of antibiotics is being reduced because of the development of resistance to them.

“I am sure this new guideline will be welcomed as a useful tool for all those healthcare professionals working in this area.”

Early-onset neonatal infections are usually caused by organisms from the mother’s genital tract, such as group B Streptococcus (GBS), E.coli, Pseudomonas and Klebsiella.

Such infections may develop suddenly and rapidly, with mortality particularly high in premature babies and those with a low birth weight, Nice said.

The infections may also cause babies to develop cortical lesions in the brain, and subsequently cause neuro-developmental delay.

NICE’s recommendations now include:

  • Treating babies with suspected early-onset neonatal infection within one hour of the decision to treat.
  • Using antibiotics benzylpenicillin and gentamicin as the first-choice treatment for suspected early-onset neonatal infection.
  • Performing a blood culture before administering the first dose of antibiotics.
  • Offering child birth antibiotic prophylaxis in a timely manner to women whose babies are at higher risk of infection.

Mark Turner, senior lecturer and consultant in neonatology at the University of Liverpool and Liverpool Women’s Foundation Trust, said: “The NHS needs to prioritise treatment for sick babies as well as ensure antibiotics are used sensibly.”

A Department of Health spokesman added: “It can be very distressing to watch and care for a sick child especially when they are very young. This guidance will help clinicians to make an informed decision and offer the best high-quality care.”

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