In England and Wales, over 49,000 babies will be admitted to hospital with an infection each year and over 5,000 babies are born with infection¹.

The National Institute for Health and Care Excellence (NICE) has issued a new quality standard which sets out priorities for healthcare professionals on the use of antibiotics to prevent and treat infections in newborn babies.

Professor Gillian Leng, deputy chief executive and director of health and social care at NICE said: “Giving prompt treatment with antibiotics helps to save the lives of many newborn babies every year. This new quality standard sets out how healthcare professionals can quickly and effectively prescribe antibiotics to those pregnant women and babies who need it the most.”

The quality standard includes 6 statements to help reduce newborn deaths and improve the treatment of pregnant women and babies who need antibiotics for an infection, including:

• Thoroughly assessing pregnant women and newborn babies to identify any clinical signs that put a newborn at risk of infection.
• Offering a preventative course of antibiotics to women as soon as possible during labour if they are at risk of passing an infection on to their newborn².
• Administering antibiotics within 1 hour if it is decided that a newborn needs treatment, even if test results are yet to come through.

Professor Leng added: “We also know that there are times when babies are given antibiotics when they are not needed. This standard sets out how healthcare professionals should responsibly prescribe antibiotics in newborn babies to make sure they are not exposed to unnecessary treatments. This will prevent many babies developing a resistance to antibiotics when they grow up and may also reduce the risk of having further problems, such as eczema and asthma.”

To ensure appropriate prescribing the standard also states that any newborn baby who starts antibiotic treatment should be reassessed at 36 hours to check whether or not they still need them. The reassessment should include any test results that weren’t previously considered. Antibiotic treatment may be stopped if the initial suspicion of infection was not strong, test results are negative and the baby’s clinical condition is reassuring³.

Christopher Head, chief executive at Meningitis Research Foundation (MRF) said: “MRF are delighted to see the publication of this NICE quality standard.  Newborns have underdeveloped immune systems putting them at risk of getting infections which can lead to meningitis and septicaemia. Because these diseases become life-threatening within hours, identification and treatment are time critical. The new NICE quality standard will save lives by ensuring that newborns with infections are treated promptly and cases are prevented by treating pregnant women whose babies are at high risk.”

The full standard is available at /guidance/QS75.

Ends

For more information call the NICE press office on 0300 323 0142 or out of hours on 07775 583 813.

Notes to Editors

Further information

1. Neonatal infection is present in 8 of every 1000 live births and 71 of every 1000 neonatal admissions. About 700,000 women give birth in England and Wales each year which equates to:
   • 49,700 newborn babies admitted to hospital with infection
   • 5,600 newborn babies with infection at birth.
2. Babies are at risk of early-onset neonatal infection if the mother has had a previous baby with an invasive group B streptococcal infection, or has group B streptococcal colonisation, bacteriuria or infection in the current pregnancy.
3. Reassessment of the need for antibiotic treatment includes considering blood culture, C-reactive protein level, clinical condition and the strength of the initial clinical suspicion of infection. Antibiotic treatment may be stopped if blood culture is negative, initial suspicion of infection was not strong, the baby has no clinical indicators of infection and C-reactive protein levels are reassuring.

About the quality standard

4. The quality standard is available at /guidance/QS75.