Recommendation ID
CG149/4
Question
Investigations during antibiotic treatment:- What is the clinical and cost effectiveness of laboratory investigations used individually or in combination to exclude early-onset neonatal infection in babies receiving antibiotics for suspected infection?
Any explanatory notes
(if applicable)
Why this is important:- The systematic reviews conducted for the guideline identified limited evidence relating to investigations used to guide the decision to stop antibiotic treatment in babies receiving antibiotics for suspected early-onset neonatal infection. One study evaluated procalcitonin-guided decision making for identifying babies in whom antibiotic treatment could safely be stopped, but the approach used was at an early stage of development and had not been
evaluated fully.
The guideline recommendations reflected uncertainty about the diagnostic test accuracy of laboratory investigations used individually or in combination, and further research involving sufficiently powered studies is needed to evaluate this. The ideal study design would be a randomised controlled trial that compares clinical outcomes associated with particular investigation and treatment termination strategies. The next best design would be a prospective cohort study to determine the diagnostic test accuracy of an investigation strategy evaluated in a clinically relevant group of babies. The research should examine clinical effectiveness or diagnostic test accuracy in preterm and term babies separately.

Source guidance details

Comes from guidance
Neonatal infection (early onset): antibiotics for prevention and treatment
Number
CG149
Date issued
August 2012

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 03/09/2012