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BRIEF RESEARCH REPORT article

Front. Pediatr.
Sec. Neonatology
Volume 12 - 2024 | doi: 10.3389/fped.2024.1471463

A national survey of first line antibiotic use in neonatal units - and the potential scope for iatrogenic sensorineural hearing loss prevention

Provisionally accepted
Jennifer Peterson Jennifer Peterson 1,2*Lauren Muddiman Lauren Muddiman 2Francesca Groves Francesca Groves 2Nicola Booth Nicola Booth 2William G. Newman William G. Newman 3John H. McDermott John H. McDermott 3Ajit Mahaveer Ajit Mahaveer 2
  • 1 Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, England, United Kingdom
  • 2 Manchester University NHS Foundation Trust (MFT), Manchester, United Kingdom
  • 3 Centre for Genomic Medicine, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, England, United Kingdom

The final, formatted version of the article will be published soon.

    Objective National Institute for Clinical Excellence (NICE) guidance for the management of neonatal sepsis recommends a first-line antibiotic regimen containing an aminoglycoside (gentamicin). Aminoglycoside exposure causes sensorineural hearing loss in individuals with a specific mitochondrial genetic variant (m.1555A>G). This variant can be detected promptly (in <30minutes) by a point of care test. NICE does allow for variation in antibiotic regimes depending on local microbiology guidance. As practices can vary, this survey aimed to determine the current use of first-line antibiotic agents within neonatal units and postnatal wards across the UK.Design and setting A telephone survey was conducted across all neonatal units in the United Kingdom. Responses were requested from a member of the neonatal team experienced in neonatal septic screening processes. One response was recorded per unit.Of the 187 neonatal units, 186 (99%) responded to the survey. One unit declined to participate. The survey results show most neonatal units (93%) and postnatal wards (74%) across the United Kingdom use aminoglycosides as first-line antibiotic agents. Antibiotic regimes varied between different units and between different locations within the same hospital (NICU versus postnatal wards). In cases where there was a contraindication to aminoglycosides, the most common alternative antibiotic was cefotaxime.Conclusions Most neonatal units in the UK use an aminoglycoside antibiotic as firstline agent for suspected sepsis. This places infants with the m.1555A>G genetic variant at risk of iatrogenic hearing loss. There needs to be integration of point-of-care genetic testing within the neonatal septic screening pathway.

    Keywords: neonates, Technology, Audiology, Genetics, Hearing Loss

    Received: 27 Jul 2024; Accepted: 07 Oct 2024.

    Copyright: © 2024 Peterson, Muddiman, Groves, Booth, Newman, McDermott and Mahaveer. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Jennifer Peterson, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, M13 9PL, England, United Kingdom

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.