Abstract:
Background: Improving neonatal care and mortality associated with it has been a challenge and is
impeding the achievement of reaching our goals for decreasing under five mortality. One of the major
causes of neonatal mortality is neonatal sepsis. Our setup has limitations in diagnosis as well as
understanding the bacteriologic profile and antibiotic sensitivity. So, it is very important to understand the
factors that are associated with failure of response to treatment so we can implement an early, targeted,
appropriate and aggressive management that is key to reduce mortality associated with sepsis.
Objectives: This research aims to assess failure of response to first line antibiotic therapy in neonatal
sepsis and associated factors.
Methods: Is a retrospective cross-sectional study with internal comparison which targeted neonates who
are admitted with the diagnosis of neonatal sepsis for the last two year in St Peter hospital. There were a
total of325 neonatal sepsis case admitted in the last two years and study subjects were collected from all
charts retrieved. And data was retrieved from the sampled charts through data abstraction sheet and
analyzed though SPSS 21.
Results: Early onset neonatal sepsis accounted for SI % of cases and Ampicillin/Gentamycin was the
most commonly used first line empiric antibiotic in 95% of cases and Ampicillin/Cefotaxime was the
most commonly used empiric second line therapy in 44% of cases. The prevalence of failure to response
to first line antibiotic therapy in neonates diagnosed to have neonatal sepsis was 25.2%. Previous history
of admission was 7.4 times likely to be associated with an increased failure to respond to first line therapy
whereas late onset neonatal sepsis and presence of Meningomyeleocele were also associated with an
increased risk of failure to respond with an odd of2.3 and S.3. respectively.
Conclusion: There is a high incidence of failure to antibiotic therapy which is associated with high
mortality. ............................................. Thesis available at ACIPH Library