Analysis of the indication of antibiotic therapy in low birth weight preterm infants with presumed early-onset sepsis

Background: Early-onset sepsis (EOS) is a syndrome with high morbidity and mortality, being a significant component of this rate, both due to the difficult clinical and laboratory diagnosis, as well as the urgency of intensive care and antibiotic therapy. The objective of this study was to analyze the criteria used for the empirical treatment of presumed EOS in a public maternity hospital in the state of Pará, Brazil. Methods: A nonrandomized case-control study conducted by collecting data from 483 records of low birth weight preterm infants admitted in intensive care unit at a referral hospital in the Amazon region in 2017 and using antibiotic therapy in the first forty-eight hours of life. To analyze the diagnostic criteria of EOS, 152 newborns were divided into two groups with the presence of criteria (case group) and 331 without criteria (control group). Results: It was observed that birth weight, gestational age, first minute Apgar score, need of orotracheal intubation resuscitation, hypothermia, cyanosis and bradycardia were the most related neonatal factors to the diagnosis of EOS, associated with the presence of urinary tract infection and leukorrhea during pregnancy. Conclusion: Most of the factors related to EOS found in this study are potentially preventable by quality prenatal and perinatal cares, being extremely important for reducing the mortality associated with this cause.