Shorter antibiotic courses effective for serious newborn infections, says study

A pioneering Indian study led by Dr Sourabh Dutta, Professor, Department of Neonatology, PGIMER, has found that shorter antibiotic courses are just as effective as longer ones for treating many serious newborn infections.

Published in The Lancet Clinical Medicine, the study represents a major stride towards reducing unnecessary antibiotic use in fragile newborns and combating global antibiotic resistance.

The landmark paper ‘Shorter or biomarker-guided antibiotic durations for common serious neonatal infections: A collection of noninferiority meta-analyses’ was authored by a consortium of leading neonatologists from across India, including co-lead author Dr Nandkishor Kabra, Surya Hospitals, Mumbai, and collaborators from Manipal, Pune, Chennai, Chandigarh and Hyderabad. Antibiotics remain lifesaving for newborns suffering from bacterial infections, yet excessive or prolonged use increases the risk of antibiotic resistance, extended hospital stays and drug-related side effects. Premature and critically ill infants are especially vulnerable, often receiving antibiotics for longer than necessary due to a lack of robust evidence guiding shorter treatments.

The researchers systematically analysed data from several studies comparing short and standard antibiotic durations for common neonatal infections. They also examined the use of “biomarker-guided” strategies, where treatment duration is determined by blood test results that indicate infection activity.

The findings suggest that a seven-day antibiotic course may suffice for most cases of proven neonatal blood infection, compared to the traditional 10-14 days. Moreover, discontinuing antibiotics when biomarker levels normalise was found to be equally safe and effective, offering a personalised approach to treatment. However, the study highlighted limited evidence for conditions such as meningitis, urinary tract infections and fungal infections, identifying them as key priorities for future research.