Clinical Study On Antibiotic De-escalation Therapy For Neonatal Severe Infection

Objective: To investigate the clinical efficacy and safety of antibiotic de-escalation therapy in the treatment of neonatal severe infection,and to provide a basis for clinical implementation of de-escalation therapy.Methods: A total of 204 neonates admitted to the neonatal ward of our hospital with diagnosis of severe infection from January 2019 to June 2020 were collected,and divided into observation group(antibiotic de-escalation therapy group)and control group(non-de-escalation therapy group)according to the antibiotic treatment methods,the demographic data,clinical characteristics,antibiotic use and clinical outcomes of the children were retrospectively analyzed.We compared the total duration of antibiotic use,length of hospitalization,mortality,antibiotic-related costs,incidence of recurrent infections,and incidence of adverse reactions between the two groups to investigate the safety and effectiveness of antibiotic de-escalation therapy in neonatal severe infections.Results: A total of 204 neonates were included,101 cases in the de-escalation group and 103 cases in the non-de-escalation group.There were no statistically significant differences between the two groups in terms of maternal pregnancy status,demographic characteristics,clinical manifestations(except fever),and inflammatory indexes(p>0.050),and there were more children in the de-escalation group having fever as a clinical manifestation than in the non-de-escalation group(p=0.025).there were no significant differences between the two groups in terms of total duration of antibiotic use(p=0.220),length of hospital stay(p=0.281),incidence of recurrent infections(p=1.000)and incidence of adverse reactions(p=0.406),and the cost associated with antibiotics was less in the de-escalation group compared with the non-de-escalation group,which was statistically significant(p=0.014).Conclusions: Antibiotic de-escalation therapy can effectively control severe neonatal infections without increasing the total duration of antibiotic use,length of hospital stay,or incidence of recurrent infections in neonates,and without an increase in the incidence of adverse effects,in addition,it can reduce the costs associated with antibiotics and reduce the economic burden,indicating that antibiotic de-escalation therapy is an effective and safe treatment strategy in neonatal severe infections.