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Antifungal agents

Variability in Antibiotic and Antifungal Treatment Practices for Neonatal Sepsis and Meningitis in UK NICUs

Strategic Insights

— 1 min read

A recent survey of 53 UK neonatal intensive care units (NICUs) has shed light on the current practices of antibiotic and antifungal treatment for sepsis and meningitis. Researchers from the Neonatal Intensive Care Unit at Ashford and St Peter's NHS Foundation Trust in Chertsey, UK, conducted a nationwide survey to understand the variation in treatment practices among NICUs. The results reveal a high degree of inconsistency in antibiotic regimens used for early- and late-onset sepsis, meningitis, and antifungal prophylaxis.

Key Takeaways:

  • 96% of NICUs recommended a penicillin and aminoglycoside combination as the first-line treatment for early-onset sepsis, while only 21% specified a second-line antibiotic regimen.
  • For late-onset sepsis, 98% of NICUs provided specific guidance on empirical first-line antibiotic treatment, with empirical narrow-spectrum antibiotics as the first-line treatment for term neonates in 79% of units.
  • The practice of routine antifungal prophylaxis has increased since the last UK survey in 2006-07 but remains neither universal nor consistent, with only 54% of units including specific recommendations for neonates with indwelling central venous catheters.
  • 66% of NICUs included cefotaxime in their empirical meningitis regimens, and 85% of units had clear guidelines for antifungal prophylaxis.
  • The survey highlights the need for standardized treatment guidelines for NICUs, particularly for preterm neonates and those with indwelling central venous catheters.

Statistics:

  • 53 UK NICUs participated in the survey between January and May 2024.
  • 100% of visited NICUs provided guidelines for antibiotic treatment of early- and late-onset sepsis and antifungal prophylaxis.
  • 96% of NICUs recommended a penicillin and aminoglycoside combination as the first-line treatment for early-onset sepsis.
  • 98% of NICUs provided specific guidance on empirical first-line antibiotic treatment for late-onset sepsis.

Sources:

  • "Current antibiotic and prophylactic antifungal drug policies in UK neonatal intensive care units: a national survey," by Rishini Wanigasekara, et al., JAC-Antimicrobial Resistance, 2025;7(5).
  • World Disease Weekly, "Research Conducted at Neonatal Intensive Care Unit Has Provided New Information about Meningitis," November 4, 2025; p 60.

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