{"id":40887,"date":"2019-12-27T09:32:08","date_gmt":"2019-12-27T14:32:08","guid":{"rendered":"https:\/\/www.healthynewbornnetwork.org\/?post_type=news-item&p=40887"},"modified":"2019-12-26T15:00:59","modified_gmt":"2019-12-26T20:00:59","slug":"most-physicians-dont-follow-who-guidelines-in-neonatal-pediatric-sepsis","status":"publish","type":"news-item","link":"https:\/\/www.healthynewbornnetwork.org\/news-item\/most-physicians-dont-follow-who-guidelines-in-neonatal-pediatric-sepsis\/","title":{"rendered":"Most Physicians Don’t Follow WHO Guidelines in Neonatal, Pediatric Sepsis"},"content":{"rendered":"

This article was originally published by Contagion Live<\/a><\/em><\/p>\n

 <\/p>\n

More than 4 million newborns and children suffer cases of sepsis each year, but a new study concluded that in the majority of those cases, patients don\u2019t receive the World Health Organization (WHO\u2019s) recommended first- or second-line therapy.<\/p>\n

Those are the findings of a new study based on 2015 data from 297 hospitals in 56 countries.<\/p>\n

Writing in The Pediatric Infectious Disease Journal<\/em><\/a>, Charlotte Jackson, PhD, of the University of London, and colleagues, say there are many reasons a clinician might choose to go against WHO guidelines. However, they say the data make clear that the global medical community has diverse opinions on how best to treat the condition.<\/p>\n

\u201cOur data suggest that there is no global consensus on which drugs to use to treat neonatal or pediatric sepsis,\u201d Jackson and colleagues wrote.<\/p>\n

At the time of the study, in 2015, the WHO recommended gentamicin with ampicillin or benzylpenicillin as the first-line treatment for infants and children diagnosed with sepsis.<\/p>\n

Ceftriaxone was the preferred second-line treatment.<\/p>\n

In analyzing the data, Jackson and colleagues found just 185 of 824 neonates with sepsis were given the first-line treatment, while 9 neonates were prescribed the second-line treatment.<\/p>\n

Among children, just 9 out of 786 were prescribed the first-line treatment, and an additional 102 were given the second-line treatment.<\/p>\n

In total, that means just 23.5% of neonatal patients and 14% of children were prescribed the first- or second-line treatment for sepsis. In the study, \u201cneonates\u201d were defined as newborns up to 30 days old, and children were defined as children between 1 month and 18 years of age.<\/p>\n

\u201cAlthough the WHO-recommended first-line and second-line treatments were the most commonly prescribed overall, most patients were not receiving these treatments,\u201d Jackson and colleagues wrote. \u201cThis was true even for empiric treatment, which is influenced by expected, rather than confirmed, resistance.\u201d<\/p>\n

The study found 44 different monotherapies were used at the nearly 300 hospitals included in the study. One hundred and ninety-two combination therapies were prescribed, according to the data.<\/p>\n

The vast majority of cases (670 neonates and 576 children) involved empiric prescribing. The combinations of ampicillin\/gentamicin and benzylpenicillin\/gentamicin were the most frequently used combinations for neonates. However, the data showed a wide variation in prescribing.<\/p>\n

\u201cAmongst those receiving empiric treatment only, 108 different antibiotic regimens (mono- or combination therapy) were recorded for neonates and 137 for children, including WHO-recommended first- and second-line treatments,\u201d the study reported.<\/p>\n

Jackson and colleagues also found significant variation among high-income countries and low- and middle-income countries. In high-income countries, the most commonly prescribed treatment for newborns was the WHO\u2019s recommended first-line treatment, and the most commonly prescribed treatment for children was the recommended second-line treatment.<\/p>\n

However, among low- and middle-income countries (LMICs), meropenem was most often prescribed for both neonates (15.9%) and children (14.6%).<\/p>\n

Roberta L. DeBiasi, MD, MS, chief of the Division of Pediatric Infectious Diseases at Children\u2019s National Hospital, in Washington DC, said there are many reasons providers might deviate from recommendations.<\/p>\n

\u201cWHO has suggested alternatives including oral antibiotics for situations where standard IV [intravenous] therapy is not selected,\u201d she told Contagion\u00ae.<\/em> \u201cIn some hospitals or countries that have very high rates of antimicrobial resistance, particularly for gram-negative organisms, it\u2019s possible that broader spectrum antibiotics are selected for that reason.\u201d<\/p>\n

Jackson and colleagues said antimicrobial resistance may be one of the reasons physicians in LMICs often avoided the WHO-recommended treatments.<\/p>\n

\u201cThe high use of meropenem in LMICs may partly reflect high levels of resistance to the recommended antibiotics amongst common sepsis pathogens,\u201d they said.<\/p>\n

The study found that a majority of cases for both neonates and children were recorded as hospital-acquired infections (HAIs), rather than community-acquired infections. In both neonates and children, physicians were significantly less likely to prescribe the recommended treatments in cases of HAIs.<\/p>\n

Jackson and colleagues said these types of prescribing decisions are necessary deviations.<\/p>\n

\u201cContext-specific approaches, such as weighted incidence syndromic combination antibiograms, may be helpful, although not necessarily straightforward to implement,\u201d Jackson wrote. \u201cRobust antimicrobial stewardship programs are needed globally to ensure consistency with appropriate guidelines.\u201d<\/p>\n

DeBiasi said the organisms responsible for neonatal sepsis are well-known, including gram-negatives, Group B Streptococcus, Listeria<\/em>, and Staphylococcus aureus<\/em> and S epidermidis<\/em>.<\/p>\n

\u201cStandard empiric antibiotic treatment regimens cover these possibilities,\u201d she said. \u201cOnce a specific organism is identified then the treatment is tailored specifically to that organism. In general, there\u2019s not a need for \u2018new therapies\u2019 for neonatal sepsis, just appropriate application of antibiotic regimens that cover the usual organisms causing neonatal sepsis.\u201d<\/p>\n

Another reason for the prevalence of deviation might have to do with the specific sampling of hospitals. The investigators wrote that the sample was not a representative sample of all hospitals worldwide, meaning it is possible that more hospitals are in fact following guidelines than is indicated by this study.<\/p>\n

Furthermore, Jackson and colleagues note that several hospitals whose data was included in the study are tertiary health care centers that are focused on research.<\/p>\n

\u201c[C]linicians here might be expected to be particularly aware of guidelines but may also see complex patients who may require nonstandard treatments,\u201d they wrote.<\/p>\n

The study also notes that the available data did not include patient-specific factors that might lend important context to the prescribing decisions. For instance, the data set did not include information on whether the particular patients who were given therapies that deviated from WHO recommendations had previously received the recommended treatments prior to the study window. Crucially, the data also did not include information on patient outcomes, making it impossible to judge the degree to which the deviations in prescribing had the intended effect.<\/p>\n

Jackson and colleagues write that additional studies are needed to get a better sense of the relationships between deviations and outcomes.<\/p>\n

\u201cFuture work should determine whether the treatments used are appropriate, accounting for the diversity of sepsis pathogens globally, and consider whether guidance should be updated to allow for varying patterns of antimicrobial resistance worldwide,\u201d they wrote.<\/p>\n

Indeed, while sepsis is not the subject of a robust pharmaceutical pipeline, it has received a significant amount of research attention in recent years as investigators attempt to cut down on the rates of mortality among patients with sepsis.<\/p>\n

DeBiasi said sepsis and similar infections are often deadly in neonates.<\/p>\n

\u201cNeonatal sepsis occurs all over the world, with 1 million deaths per year,\u201d she said. \u201cTaking into account all serious bacterial infections in neonates there are 3 million deaths a year. Mortality is higher in low income, resource-poor countries, and the majority of deaths occur in these countries.\u201d<\/p>\n

DeBiasi said overcrowding and lack of access to prenatal care can play a role in the prevalence of sepsis, as can lack of access to health care and\/or necessary antibiotics.<\/p>\n

Other times, mortality is the result of an inability to detect sepsis soon enough. New York state in 2013 passed a series of regulations following the death of a 12-year-old boy from sepsis. A study out earlier this year found the new protocols resulted in a significant drop<\/a> in sepsis mortality.<\/p>\n

Meanwhile, in the United Kingdom, a digital sepsis alert system<\/a> has shown promise reducing mortality risk.<\/p>\n

In addition, better diagnostic testing might also help solve the problem. Another study, published this month, found a rapid blood assay appears to have the ability to predict mortality risk<\/a> in patients with sepsis.<\/p>\n","protected":false},"author":7211,"featured_media":40889,"template":"","acf":[],"yoast_head":"\nHealthy Newborn Network<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.healthynewbornnetwork.org\/news-item\/most-physicians-dont-follow-who-guidelines-in-neonatal-pediatric-sepsis\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Most Physicians Don't Follow WHO Guidelines in Neonatal, Pediatric Sepsis - Healthy Newborn Network\" \/>\n<meta property=\"og:description\" content=\"This article was originally published by Contagion Live   More than 4 million newborns and children suffer cases of sepsis each year, but a new study concluded that in the majority of those cases, patients don\u2019t receive the World Health Organization (WHO\u2019s) recommended first- or second-line therapy. 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https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Most-physicians-dont-follow-WHO-guidelines-284x300.jpg 284w, https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/Most-physicians-dont-follow-WHO-guidelines.jpg 854w\" sizes=\"(max-width: 768px) 100vw, 768px\" \/>","author_name":"HNN Team","author_image":"<img src=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/themes\/hnn\/dist\/images\/member-default.jpg\" alt=\"\" class=\"avatar avatar-32 photo\" height=\"32\" width=\"32\"\/>","acf_custom_fields":{"external_link":"https:\/\/www.contagionlive.com\/news\/most-physicians-dont-follow-who-guidelines-in-neonatal-pediatric-sepsis","publication_date":"20191125","publication":"Contagion Live","partners":[],"issues":[{"ID":411,"post_author":"7211","post_date":"2016-01-20 18:01:00","post_date_gmt":"2016-01-20 18:01:00","post_content":"[vc_row full_width=\"stretch_row\" css=\".vc_custom_1453403441710{margin-top: -60px !important;padding-top: 30px !important;padding-bottom: 30px !important;background-color: #ffffff !important;}\"][vc_column width=\"1\/2\"][vc_column_text]\r\n<h2>Identification of possible serious bacterial infection (PSBI) and timely initiation of appropriate antibiotic treatment can dramatically increase a newborn\u2019s chance of survival.<\/h2>\r\nRecent research has shown that when hospitalization is not possible, a safe, effective, and simpler antibiotic treatment can be provided in lower-level facilities.[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\" el_class=\"issue-stats\"][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-red\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">600<\/span>k<\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1666120914939{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">number of <a href=\"https:\/\/www.who.int\/publications\/i\/item\/9789241512930\">neonatal deaths attributed to severe infections<\/a> annually<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-yellow\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">10<\/span><\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1666120847543{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percent of newborns who <a href=\"https:\/\/www.who.int\/publications\/i\/item\/9789241512930\">develop signs of PSBI and require treatment<\/a>\u00a0<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner][vc_column_text]\r\n<h6 style=\"text-align: center;\"><span style=\"font-style: italic;\">All data on this page represents the most recent data available, unless otherwise noted. Please visit our\u00a0<\/span><a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\"><span style=\"font-style: italic;\">Newborn Numbers<\/span><\/a><span style=\"font-style: italic;\">\u00a0page and download the Excel spreadsheet to explore the data further.<\/span><\/h6>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row css=\".vc_custom_1455919301204{margin-top: 30px !important;margin-bottom: 30px !important;}\"][vc_column][vc_column_text]\r\n<h2><b>PSBI Community of Practice <\/b><strong>(CoP)<\/strong><\/h2>\r\nThe PSBI CoP defines itself as \u201cgroups of people who share a concern or passion for something they do and learn how to do it better as they interact regularly.\u201d These groups facilitate the collective pursuit of a shared interest through relationship building, learning and information sharing about a specific practice area or need. They also stimulate dialogue, capture and diffuse existing knowledge, support collaboration, organize members around purposeful action, generate new knowledge and help to connect people who might not ordinarily interact. Given these features, COPs are uniquely positioned to help drive the research-to-use process by supporting stakeholder engagement, knowledge management, research translation, and research dissemination.[\/vc_column_text][vc_text_separator title=\"Key resources\"][vc_column_text]\r\n<ul>\r\n \t<li><a href=\"http:\/\/apps.who.int\/iris\/bitstream\/10665\/181426\/1\/9789241509268_eng.pdf\">Managing possible serious bacterial infection in young infants when referral is not feasible.<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/operationalizing-management-of-sick-young-infants-with-possible-serious-bacterial-infection-psbi-when-referral-is-not-feasible-in-the-context-of-existing-maternal-newborn-and-child-health-programm\/\">Operationalizing management of sick young infants with possible serious bacterial infection (PSBI) when referral is not feasible in the context of existing maternal, newborn, and child health programmes<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.thelancet.com\/pdfs\/journals\/langlo\/PIIS2214-109X(14)70347-X.pdf\">Safety and efficacy of alternative antibiotic regimens compared with 7-day injectable procaine benzyl penicillin and gentamicin for outpatient treatment of neonates and young infants with clinical signs of severe infection when referral is not possible: a randomized, open-label, equivalence trial.<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(14)62284-4\/abstract\">Simplified antibiotic regimens compared with injectable procaine benzyl penicillin plus gentamicin for treatment of neonates and young infants with clinical signs of possible serious bacterial infection when referral is not possible: a randomized, open-label, equivalence trial.<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(14)62285-6\/abstract\" target=\"_blank\" rel=\"noopener noreferrer\">Oral amoxicillin compared with injectable procaine benzyl penicillin plus gentamicin for treatment of neonates and young infants with fast breathing when referral is not possible: a randomized, open-label, equivalence trial<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(14)62285-6\/abstract\" target=\"_blank\" rel=\"noopener noreferrer\"> Outpatient treatment for neonates and young infants with clinically suspected severe infection<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/institutionalizing-the-management-of-sick-young-infants-kenyas-experience-in-revising-national-guidelines-on-integrated-management-of-newborn-and-childhood-illnesses\/\">Institutionalizing the Management of Sick Young Infants: Kenya\u2019s Experience in Revising National Guidelines on Integrated Management of Newborn and Childhood Illnesses<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][\/vc_column][vc_column][\/vc_column][\/vc_row]","post_title":"Treatment of possible severe bacterial infection (PSBI)","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"treatment-of-possible-severe-bacterial-infection","to_ping":"","pinged":"","post_modified":"2023-11-13 11:49:50","post_modified_gmt":"2023-11-13 16:49:50","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=411","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"},{"ID":126,"post_author":"7211","post_date":"2015-10-21 15:19:14","post_date_gmt":"2015-10-21 15:19:14","post_content":"[vc_row full_width=\"stretch_row\" css=\".vc_custom_1453403441710{margin-top: -60px !important;padding-top: 30px !important;padding-bottom: 30px !important;background-color: #ffffff !important;}\"][vc_column width=\"1\/2\"][vc_column_text]\r\n<h2>Severe newborn infections\u2014including sepsis, meningitis, and <a href=\"https:\/\/www.healthynewbornnetwork.org\/issue\/pneumonia\/\">pneumonia<\/a>\u2014are a major cause of morbidity and mortality among newborns in low- and middle-income countries.<\/h2>\r\nRecent analyses estimate that globally, approximately 400,000 newborns die each year as a result of severe infections, over one-sixth of the total burden of newborn deaths. Most of these deaths could be averted through:\r\n<ol>\r\n \t<li>preventive measures, such as improving hygiene practices, and<\/li>\r\n \t<li>timely and appropriate care for sick newborns.<\/li>\r\n<\/ol>\r\n[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\" el_class=\"issue-stats\"][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-red\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">17<\/span><\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1456252549558{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percentage of neonatal deaths caused by severe bacterial infections<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-yellow\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">400<\/span>k<\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1456252596727{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">number of newborns who die each year as a result of severe infections<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-blue\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><b><span class=\"ticker\">8<\/span><\/b><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1653422219529{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\">percentage of neonatal deaths caused by pneumonia<\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner][vc_column_inner][vc_column_text]\r\n<h6 style=\"text-align: center;\"><em>All data on this page represents the most recent data available, unless otherwise noted. Please visit our <a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn Numbers<\/a>\u00a0page and download the Excel spreadsheet to explore the data further.<\/em><\/h6>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" css=\".vc_custom_1453407008439{padding-top: 0px !important;padding-bottom: 0px !important;background-color: #f6f6f6 !important;}\"][vc_column][vc_text_separator title=\"Prevention\"][vc_row_inner equal_height=\"yes\"][vc_column_inner][vc_column_text]Preventive measures during the antenatal and intrapartum periods can reduce the risk of congenital and newborn infections while protecting the health of the mother. Before and during pregnancy, women can be screened and treated for syphilis and vaccinated against diseases like tetanus. In addition to preventing subsequent infection in the newborn, treating maternal infections during pregnancy \u2013 such as antibiotics for prolonged, preterm rupture of membranes or chorioamnionitis -- can also greatly reduce the risk for preterm birth, a leading cause of newborn mortality as well as prevent serious newborn infection.\r\n\r\nClean birth practices reduce the rate of newborn infections at home and implementation of consistent, high-quality infection control practices reduces newborn infections in facility settings. Hygienic umbilical cord care, including using a sterile instrument to cut the cord and, when appropriate and per national guidelines, <a href=\"https:\/\/www.healthynewbornnetwork.org\/issue\/chlorhexidine-for-umbilical-cord-care\/\">applying chlorhexidine to the newborn cord stump<\/a>, can also reduce infection and preventable death. <a href=\"https:\/\/www.healthynewbornnetwork.org\/issue\/breastfeeding-and-feeding-of-small-and-sick-newborns\/\">Early and exclusive breastfeeding<\/a> also reduces the likelihood of newborn infections in several ways, including providing critical support to boost immune system development and avoiding the introduction of potentially harmful substances to the immature gut.\r\n\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" css=\".vc_custom_1453407008439{padding-top: 0px !important;padding-bottom: 0px !important;background-color: #f6f6f6 !important;}\"][vc_column][vc_text_separator title=\"Management\"][vc_row_inner equal_height=\"yes\"][vc_column_inner][vc_column_text]WHO recommends that newborns and young infants should be hospitalized when they have signs of possible <a href=\"https:\/\/www.healthynewbornnetwork.org\/issue\/treatment-of-possible-severe-bacterial-infection\/\">serious bacterial infection, and treated<\/a> with 7 days of a combination of injectable antibiotics \u2013 gentaminin and ampicillin (or penicillin). In many or most low and middle-income countries (LMICs), such hospital-based treatment is not routinely feasible for many families for a number of cultural, geographic, and financial barriers. In these circumstances, recent evidence has led WHO to recommend outpatient antibiotics to such newborns and young infants to successfully treat the illness. The recommended antibiotic course is a combination of injectable and oral antibiotics: 2 days of once-daily gentamicin combined with 7 days of twice-daily oral amoxicillin. A follow up visit at 4 days of treatment is recommended to ensure adherence to the antibiotics and to ensure improvement in the newborn\u2019s condition. When referral from outpatient facility to hospital is accepted by families, the health center provider should ensure that the newborn or young infant is first given a dose of gentamicin and amoxicillin since even short delays in initiation of treatment can mean the difference between life and death.\r\n\r\nSaving newborn lives from life-threatening infections is now indeed feasible, acceptable, and effective in reducing preventable newborn and young infant deaths, and should be a top public health priority.\r\n\r\n<strong>Key Resources:\u00a0<\/strong>\r\n<ul>\r\n \t<li><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/25274969\/\">Respiratory Distress in the Newborn <\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.everypreemie.org\/wp-content\/uploads\/2019\/09\/SafeOxygen_english_7.6.17.pdf\">Safe and effective oxygen use for inpatient care of newborns<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.everypreemie.org\/wp-content\/uploads\/2019\/09\/InfectionPrevention_english_7.6.17.pdf\">Safe and effective infection prevention for inpatient newborn care<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.everypreemie.org\/wp-content\/uploads\/2019\/07\/DNH_TechBrief_MgmtNewbornInfection_7.15.19.pdf\">Management of newborn infections during inpatient care<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.nature.com\/articles\/pr2013207\">Neonatal severe bacterial infection impairment estimates in South Asia, sub-Saharan Africa, and Latin America for 2010<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row]","post_title":"Severe infections","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"severe-infections","to_ping":"","pinged":"","post_modified":"2022-10-18 14:43:52","post_modified_gmt":"2022-10-18 18:43:52","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=126","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"}],"regions":[],"countries":[]},"_links":{"self":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/news-item\/40887"}],"collection":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/news-item"}],"about":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/types\/news-item"}],"author":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/users\/7211"}],"version-history":[{"count":0,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/news-item\/40887\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media\/40889"}],"wp:attachment":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media?parent=40887"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}