Swedish Newborn Antibiotic Use: Regional Sepsis Differences
Antibiotic Use in Swedish Newborns Varies Considerably Across regions
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Nationwide study reveals Wide Disparities in Early Antibiotic Treatment
A new nationwide study from Sweden reveals substantial variations in antibiotic use among newborns, ranging from 0.9% to 4.3% during the first week of life. The research, encompassing data from over one million infants born between 2012 and 2020 across the country – from Gällivare in the north to Ystad in the south – highlights the impact of local practices and hospital policies on early antibiotic intervention rates. The findings are published in the Archives of Disease in Childhood: Fetal & Neonatal Edition.
Regional Differences and International Benchmarks
The study focused on the proportion of newborns receiving antibiotics during their first week, a key metric for assessing neonatal care practices internationally. in regions with low sepsis rates, like those in the western world, the target is to treat no more than one percent of infants while maintaining low sepsis prevalence and mortality.
The Swedish study found significant regional differences.Western Sweden exhibited the highest antibiotic use, at 3.0%,while eastern Sweden reported the lowest at 1.3%.Importantly, sepsis prevalence remained consistently below one per thousand live births across all Swedish regions, demonstrating that lower antibiotic use doesn’t necessarily equate to increased risk.
This variation suggests that differing thresholds for antibiotic intervention, influenced by local protocols and traditions, are major contributing factors. While prevalence levels play a role, the study emphasizes the importance of standardized approaches to neonatal care.
The Risks of antibiotic Overuse in Newborns
Sepsis, a life-threatening condition triggered by an overwhelming immune response to infection, requires immediate treatment. Though, the indiscriminate use of antibiotics carries significant risks for newborns. Antibiotics disrupt the delicate balance of the gut bacterial flora, which is crucial for immune system growth and long-term health. Moreover, overuse contributes to the growing problem of antibiotic resistance, possibly rendering thes vital medications ineffective when truly needed.
Balancing Treatment and Responsible Antibiotic Stewardship
“Antibiotics are essential in the treatment of sepsis in newborns, and if you have a sicker population, then it’s reasonable for antibiotic use to be higher,” explains Johan Gyllensvärd, PhD student in pediatrics at Sahlgrenska Academy at the University of Gothenburg and a practicing pediatrician at Ryhov County Hospital in Jönköping. “However, we need to increase awareness of the overuse of antibiotics and improve at distinguishing infected and uninfected infants. This study helps highlight good examples and demonstrates that it’s possible to have a treatment rate of one percent or less of all newborns while maintaining low sepsis and mortality rates.”
The research underscores the need for greater awareness among healthcare professionals regarding appropriate antibiotic use and improved diagnostic tools to accurately identify infants who genuinely require treatment. By learning from regions with lower intervention rates, hospitals can refine their protocols and implement strategies to minimize unneeded antibiotic exposure.
Source:
Journal reference: Gyllenswaard, J., et al.(2025). Variations in antibiotic use in late preterm and term newborns from 2012 to 2020: a nationwide population-based observational study. Archives of Disease in Childhood – Fetal and neonatal Edition. doi.org/10.1136/archdischild-2025-328944.