Less antibiotics for babies

Too much antibiotics for babies: can we do better?

There is scientific evidence that antibiotic therapy in newborn babies may have harmful consequences later in life. Antibiotics change the microbe composition of the gut, may compromise breastfeeding and increase the risk for eczema, allergy, obesity, diabetes and inflammatory bowel diseases. There is also a real danger that we will not be able to treat severe infections in the future, due to resistance to antibiotics. The World Health Organization (WHO) has recognized that we face a serious threat to public health globally. With your help, we will document the use of antibiotics in newborn babies in 13 countries and over 50 hospitals. Our study will collect this information to improve our understanding of the problem of antibiotic overtreatment in babies, raise awareness about this issue, and identify practices associated with better outcomes.

Raising awareness can make a difference

Communicating on this issue is a very important step if we want doctors to evaluate and adapt their practice. By conducting this large study, we want to identify hospitals or countries that perform better, with practices associated with a lower level of antibiotics prescription, and a safe treatment of the babies that really need antibiotics. Our results will be shared with other hospitals, giving everyone a chance to learn from them. This project will have an impact! With the potential to improve the lives of many babies worldwide. Doctors from over 50 hospitals in 13 different countries have already agreed to be part of this project. Even more: we already built a database and the Swiss Ethics committee has approved our study. Therefore, we are ready to start and the last barrier is the lack of money for organizational costs.

How we will use your support

Many doctors from several hospitals in different countries have accepted to work for this project without any additional salary. But the study has costs that are not currently supported by the hospitals. The collection and anonymization of clinical data from thousands of babies represent a lot of work, and we need to transfer this data on a secure online database specifically designed for the study. The results of our study will be carefully analyzed by our team in Switzerland, before being shared for free in scientific conferences, peer-reviewed open access journals, and in the media. The money raised by this initiative will be used to pay for the expenses of scientists involved in data collection, for the setting up and maintenance of the study database, and for data analysis and dissemination.

Do you want to know more?

• What’s the problem with bacterial infections in babies?

Bacterial infections may end up in the death of babies and put survivors at risk of lifelong disability. For doctors, bacterial infection can be very difficult to diagnose as the signs may be initially subtle and are similar to other (less severe) conditions. As an example, a baby may have rapid breathing soon after birth, and need for additional oxygen. Rapid breathing and need of oxygen can be be signs of bacterial infection. More often, they are signs of a slightly delayed adaptation to birth, and a few hours later the baby is just fine. The consequences of untreated infections are potentially dramatic, and even a delay of one hour in initiation of antibiotic treatment can increase the risk of death. Therefore, when an infection is suspected, antibiotics are usually started immediately. In most cases however, as described in our example, the symptoms are mild and resolve rapidly, as bacterial infection was not the reason for the symptoms.

• What’s the current situation?

The good news is that the rate of proven infection within the first week of life has decreased over the last decades. Babies born at term have an overall risk of 1 out of 1000 to 1 out of 5000 for a proven infection. Nevertheless, the proportion of babies receiving antibiotics during the first week of life ranges between 2 and 16% in Europe and North America. Therefore, current approaches in different countries lead to substantial overtreatment as up to 200 babies are treated with antibiotics for 1 baby with proven infection. But all of this has not been measured with enough precision. Therefore, we don’t know which strategy is the best to safely treat babies who have bacterial infections and minimize exposure to antibiotics in the ones that don’t need these treatments.

• What’s the plan to go?

This project will take place in hospitals from 13 different countries. We will record which babies receive antibiotics, and for how long, and which ones really have a proven infection. We will then calculate an overtreatment index, which is the number of babies receiving antibiotics for 1 case with proven infection. This will help to develop novel interventions to reduce antibiotic exposure in newborns, while safely those with proven infections.

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