Prophylactic systemic antibiotics to reduce morbidity and mortality in neonates with central venous catheters

Central venous lines (long plastic tubes that have their tip ending in the big veins near the heart through which medicine and fluid can be given) are used in some newborn babies, particularly those that have been born too early or who are very sick. Babies with these lines are at risk of developing very serious blood infections, which may even cause death. Sometimes antibiotics are used to try to prevent these blood infections in babies with central venous lines. These preventive antibiotics may have unwanted side effects and could increase the likelihood of infections that are resistant to treatment. Therefore, it is possible that the risks of using antibiotics outweigh the potential benefits. Three small trials of 271 babies were included in this review. The results of these studies show that it is possible to reduce the chance of serious blood infection occurring, but that almost 10 babies need to be given preventive antibiotics to avoid one case of infection. There was no difference in the likelihood of death. There were not enough data on other important effects of the antibiotics or on the possible serious side effects. There was not much similarity between the studies included in this review. Therefore, there is currently not enough evidence to recommend routinely using antibiotics in babies with central venous lines.