In asymptomatic term and late-preterm infants with risk factors, close clinical monitoring is the safer option, allowing for adequate and timely sepsis detection while reducing unnecessary antibiotic-related harm.

What is known about antibiotics in neonates:

Neonatal early-onset sepsis is a rare but life-threatening condition and is therefore at risk of being overdiagnosed and overtreated. Antibiotics are the most commonly prescribed medication in neonatal units.

Early-life antibiotic exposure disrupts the developing microbiome, which may contribute to numerous diseases later in life, including diabetes, obesity, inflammatory bowel disease, asthma, and allergy and is also associated with mother-newborn separation, longer duration of hospital stay, and reduced breastfeeding rates.

Unnecessary antibiotic use has also been associated with adverse patient outcomes and emergence of multi- resistant organisms.

How to talk with patients and parents about cough medicine:

Avoiding unnecessary antibiotics is safe and has many advantages for your baby such as:

Close monitoring ensures that signs of severe infection are not missed.

This EAP recommendation is in accordance with Choosing Wisely recommendations of:

USA:
https://www.aafp.org/pubs/afp/collections/choosing-wisely/465.html

References:

  • Berardi A, Buffagni AM, Rossi C, et al. Serial physical examinations, a simple and reliable tool for managing neonates at risk for early-onset sepsis. World J Clin Pediatr. 2016 Nov 8;5(4):358–64. PMID: 27872823

  • Giannoni E, Dimopoulou V, Klingenberg C, Navér L, Nordberg V, Berardi A, El Helou S, Fusch G, Bliss JM, Lehnick D, Guerina N. Analysis of Antibiotic Exposure and Early-Onset Neonatal Sepsis in Europe, North America, and Australia. JAMA Network Open. 2022 Nov 1;5(11):e2243691. PMID: 36416819

  • Hooven TA, Randis TM, Polin RA. What’s the harm? Risks and benefits of evolving rule-out sepsis practices. J Perinatol. 2018 Jun;38(6):614–22. PMID: 29483569

  • Prusakov P, Goff DA, Wozniak PS, Cassim A, Scipion CE, Urzua S, Ronchi A, Zeng L, Ladipo-Ajayi O, Aviles-Otero N, Udeigwe-Okeke CR. A global point prevalence survey of antimicrobial use in neonatal intensive care units: the no- more-antibiotics and resistance (NO-MAS-R) study. EClinicalMedicine. 2021 Feb 1;32.100727. PMID: 33554094

  • Van Herk W, Stocker M, van Rossum AM. Recognising early onset neonatal sepsis: an essential step in appropriate antimicrobial use. Journal of Infection. 2016 Jul 5;72:S77-82. PMID: 27222092

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Core-MD Project

Coordinating Research and Evidence for Medical Devices (CORE-MD)

New ways to test high-risk medical devices.

 

Manufacturers of medical devices need to test their products before being allowed to market them. Specifically, they require clinical data showing their medical device is safe and efficient. In this context, the EU-funded CORE-MD project will translate expert scientific and clinical evidence on study designs for evaluating high-risk medical devices into advice for EU regulators. The project will propose how new trial designs can contribute and suggest ways to aggregate real-world data from medical device registries.


It will also conduct multidisciplinary workshops to propose a hierarchy of levels of evidence from clinical investigations, as well as educational and training objectives for all stakeholders, to build expertise in regulatory science in Europe. CORE–MD will translate expert scientific and clinical evidence on study designs for evaluating high-risk medical devices into advice for EU regulators, to achieve an appropriate balance between innovation, safety, and effectiveness. A unique collaboration between medical associations, regulatory agencies, notified bodies, academic institutions, patients’ groups, and health technology assessment agencies, will systematically review methodologies for the clinical investigation of high-risk medical devices, recommend how new trial designs can contribute, and advise on methods for aggregating real-world data from medical device registries with experience from clinical practice The consortium is led by the European Society of Cardiology and the European Federation of National Associations of Orthopaedics and Traumatology, and involves all 33 specialist medical associations that are members of the Biomedical Alliance in Europe.

EAP Representative: