Antimicrobial Therapies for Early-Onset Group B Streptococcal Sepsis: Insights from an Italian Multicenter Study

<b>Background</b>: Antimicrobial therapies used for treating group B streptococcus (GBS) early-onset sepsis (EOS) provide insight into clinicians' adherence to antimicrobial stewardship (AMS) guidelines. <b>Methods</b>: We reviewed antimicrobial therapies given to treat newborns with GBS-EOS. Data were obtained from an Italian surveillance network (including 35 birthing centers) and were prospectively collected from 1 January 2003 to 31 December 2024. Empiric and definitive therapies were classified as adequate and inadequate. <b>Results</b>: There were 967,054 live births and 200 cases of GBS-EOS, of which 43 (21.5%) were preterm and 157 (78.5%) were full-term; 35 (17.5%) out of 200 showed no signs of illness. Fourteen (7.0%) died (one full-term and thirteen preterm newborns under 34 weeks of gestation). Based on the available information, antibiotics were adequate in 106/137 (77.4%) empiric and 48/119 (40.3%) definitive therapies. The duration of antibiotic courses did not differ between severe (median 10 days, IQR 8.0-14.0) and non-severe cases (median: 10 days; IQR: 10.0-12.5; <i>p</i> = 0.68). Antibiotic treatments lasted ≥ 15 days in 34 (20.1%) out of 169 cases with available information. <b>Conclusions</b>: In this large Italian multicenter study, deviations from international recommendations in antimicrobial therapies for GBS-EOS were critical. Our findings underscore the importance of timely antimicrobial de-escalation and the need to avoid excessively prolonged courses of antimicrobials.

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Publication Details

Journal
Antibiotics
Published
2025-04-16
DOI
https://doi.org/10.3390/antibiotics14040410
Citations
1
Primary Topic
Neonatal and Maternal Infections
Type
article
Field-Weighted Citation Impact
1.88

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article

Antimicrobial Therapies for Early-Onset Group B Streptococcal Sepsis: Insights from an Italian Multicenter Study

Davide Scarponi, Nicola Laforgia, Silvia Fanaro, Daniele Santori et al.
1 citations
Antibiotics
Neonatal and Maternal Infections
1.88
article

Antimicrobial Therapies for Early-Onset Group B Streptococcal Sepsis: Insights from an Italian Multicenter Study

Davide Scarponi, Nicola Laforgia, Silvia Fanaro, Daniele Santori, Alessandra Foglianese, Licia Lugli, Chryssoula Tzialla, Alberto Berardi, Jenny Bua, Belinda Benenati, Francesca Miselli, Irene Papa, Sofia Fiore Spinedi, Giuseppe Latorre, Lucia Marrozzini, Giangiacomo Nicolini, Luisa Di Luca, Maria Eleonora Scapillati, Luca Bedetti, Lidia Decembrino, Cinzia Auriti, Roberta Creti, Valentina Capone, Sabrina Loprieno, Gianfranco Maffei, Martina Buttera, Caterina Vocale, Giacomo Biasucci, Maria Rita Pulvirenti, Enrico Rosati, Barbara Perrone, Lorenza Baroni, Lucia Gambini, Mattia Iaccheri, Giancarlo Piccinini, Maria Paola Ronchetti, Francesca Nanni, Serena Truocchio
article en
1 citations

Abstract

<b>Background</b>: Antimicrobial therapies used for treating group B streptococcus (GBS) early-onset sepsis (EOS) provide insight into clinicians' adherence to antimicrobial stewardship (AMS) guidelines. <b>Methods</b>: We reviewed antimicrobial therapies given to treat newborns with GBS-EOS. Data were obtained from an Italian surveillance network (including 35 birthing centers) and were prospectively collected from 1 January 2003 to 31 December 2024. Empiric and definitive therapies were classified as adequate and inadequate. <b>Results</b>: There were 967,054 live births and 200 cases of GBS-EOS, of which 43 (21.5%) were preterm and 157 (78.5%) were full-term; 35 (17.5%) out of 200 showed no signs of illness. Fourteen (7.0%) died (one full-term and thirteen preterm newborns under 34 weeks of gestation). Based on the available information, antibiotics were adequate in 106/137 (77.4%) empiric and 48/119 (40.3%) definitive therapies. The duration of antibiotic courses did not differ between severe (median 10 days, IQR 8.0-14.0) and non-severe cases (median: 10 days; IQR: 10.0-12.5; <i>p</i> = 0.68). Antibiotic treatments lasted ≥ 15 days in 34 (20.1%) out of 169 cases with available information. <b>Conclusions</b>: In this large Italian multicenter study, deviations from international recommendations in antimicrobial therapies for GBS-EOS were critical. Our findings underscore the importance of timely antimicrobial de-escalation and the need to avoid excessively prolonged courses of antimicrobials.

AntibioticsVol. 14(4)
University of Modena and Reggio Emilia (IT), University of Parma (IT), University of Ferrara (IT), Istituto Superiore di Sanità (IT), IRCCS Materno Infantile Burlo Garofolo (IT), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT), Ospedale Maggiore (IT), Ospedali Riuniti di Foggia (IT), Ospedale "Santa Maria delle Croci" di Ravenna (IT), Istituto Ramazzini (IT), Saint Camillus International University of Health and Medical Sciences (IT), Azienda Ospedaliera Santa Maria Degli Angeli (IT), Ospedale “M. Bufalini” di Cesena (IT), Azienda USL di Bologna (IT), Bambino Gesù Children's Hospital (IT), Ospedale G.B. Morgagni - L.Pierantoni (IT), Ospedale Infermi di Rimini (IT), Guglielmo da Saliceto Hospital (IT), Ospedale Generale Regionale Francesco Miulli (IT), University of Bari Aldo Moro (IT)
European Commission, Regione Emilia-Romagna
Good health and well-being
Openalex Percentile: Top 17%
Neonatal and Maternal Infections
1.88
DOIOpen Access PDFOpenAlex
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