Newborn Infection Prevention and Management
Newborns – especially those born prematurely and of low birth weight – can easily become infected with harmful pathogens encountered before, during and after birth. These infections account for nearly 30% of total newborn deaths globally.
To address this, MCSP infection and newborn sepsis management stresses strategies to reduce the opportunity for infection through improved intrapartum practices. This includes handwashing by birth attendants, disinfection and sterilization of equipment, minimization of vaginal examinations, and prompt diagnosis and treatment of prolonged labor. Infection prevention also warrants early and exclusive breastfeeding, clean cord care (including umbilical applications of chlorhexidine), improved maternal health and nutrition, maternal and neonatal immunizations, and antibiotic prophylaxis.
Diagnosis of neonatal infection has remained a challenge because sick newborns often present with non-specific signs and symptoms, and blood cultures. Where tests are available, they are positive in only 5-10% of suspected sepsis cases. Therefore, when there is suspected serious infection, the practice is to treat newborns presumptively with antibiotics.
Strengthening community-based capacity to deliver these treatments safely and effectively is a priority in rural and developing country contexts. Recent studies conducted in Africa and Asia have suggested a simplified combination of injectable and oral antibiotic regimes are equally efficacious as conventional injectable regimes. The World Health Organization is expected to release revised guidelines in 2015, recommending the use of simplified regimens for newborn sepsis management when hospitalization is not possible. MCSP will work with country programs interested to implement simplified antibiotic regimes for management of newborn sepsis through existing Integrated Management of Childhood Illness programs, thereby contribute to the implementation science, both at national and global levels.