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Dr. Akhilesh Kumar
Dr. Rajendra Kumar


Sepsis, Hyperbilirubinemia, Ceftriaxone, Cefotaxime


Introduction: Sepsis occurring before 28 days after birth is termed as neonatal sepsis. It is a life-threatening infection responsible for significant morbidity and mortality worldwide.

 Aim: To compare the incidence of hyperbilirubinemia in neonates given a short-term course of ceftriaxone versus cefotaxime for sepsis.

 Methods: A retrospective study conducted in Autonomous State Medical College, Shahjahanpur & Allied Pt. Ram Prasad Bismil Memorial Hospital. Study was carried out by evaluating 110 prescriptions of neonatal sepsis. 110 prescriptions were grouped into two, ceftriaxone prescribed cases included in group-A and cefotaxime prescribed cases included in group-B.  At the time of antimicrobial administration, patients were about 15-28 days old and each received at least one dose of ceftriaxone or cefotaxime during hospital admission. Patient characteristics and bilirubin levels were compared between groups.

Results: Majority of the patients were males (68.18%), weighing 3.25kg. At initial visit, an average age of patients was 21 days. Among 110 cases, elevated bilirubin levels were observed in 96(87.27%), only 14 patients had normal bilirubin levels. After treatment with antimicrobial agents, abnormally elevated bilirubin levels were noticed in 5 patients, 2 (3.50%) in ceftriaxone and 3 (5.6%) in cefotaxime treated patients. Bilirubin levels were increased in both the groups but the mean difference was not statistically significant. (p>0.05)

Conclusion: In present study we had observed hyperbilirubinemia in patients received both ceftriaxone and cefotaxime. However cefotaxime received patients had shown slightly higher bilirubin levels as compared with ceftriaxone received patients, but which is not statistically significant(p>0.05).

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1. Bakhuizen SE, de Haan TR, Teune MJ, van Wassenaer-Leemhuis AG, van der Heyden JL, van der Ham DP, et al. Meta-analysis shows that infants who have suffered neonatal sepsis face an increased risk of mortality and severe complications. Acta Paediatr. 2014;103(12):1211–8.
2. Camacho-Gonzalez A, Spearman PW, Stoll BJ. Neonatal infectious diseases: evaluation of neonatal sepsis. Pediatr Clin North Am. 2013;60(2):367–89.
3. .Karunasekera KA, Pathirana D. A preliminary study on neonatal septicaemia in a tertiary referral hospital paediatric unit. Ceylon Medical Journal. 1999; 44(2):81–6.
4. Lim NL, Wong YH, Boo NY, Kasim MS, Chor CY. Bacteraemic infections in a neonatal intensive care unit--a nine-month survey. Med J Malaysia. 1995; 50(1):59–63.
5. Moreno MT, Vargas S, Poveda R, Sáez-Llorens X. Neonatal sepsis and meningitis in a developing Latin American country. Pediatric Infectious Disease Journal. 1994;13(6):516–20.
6. Robillard PY, Nabeth P, Hulsey TC, Sergent MP, Périanin J, Janky E. Neonatal bacterial septicemia in a tropical area. Four-year experience in Guadeloupe (French West Indies). Acta Paediatr. 1993;82(8):687–9.
7. Tallur SS, Kasturi AV, Nadgir SD, Krishna BV. Clinico-bacteriological study of neonatal septicemia in Hubli. Indian J Pediatr. 2000;67(3):169–74.
8. The Who Young Infants Study Group. Clinical prediction of serious bacterial infections in young infants in developing countries. Pediatric Infectious Disease Journal. 1999;18(10 Suppl):S23–31.
9. Shane AL, Sánchez PJ, Stoll BJ. Neonatal sepsis. Lancet. 2017; 390(10104):1770–1780.
10. Schlapbach LJ, Aebischer M, Adams M, Natalucci G, Bonhoeffer J, Latzin P, et al. Impact of sepsis on neurodevelopmental outcome in a Swiss National Cohort of extremely premature infants. Pediatrics. 2011;128(2):e348–e57.
11. Zea-Vera A, Ochoa TJ. Challenges in the diagnosis and management of neonatal sepsis. Journal of Tropical Pediatrics. 2015;61(1):1–13.
12. Park SE. Prevention of neonatal group B streptococcal disease. Infection & chemotherapy. 2013;45(3):343–5
13. 13. Puopolo KM, Benitz WE, Zaoutis TE, et al. Management of neonates born at ≥35 0/7 weeks’ gestation with suspected or proven early-onset bacterial sepsis. Pediatrics. 2018;142(6):e20182894. doi:10.1542/peds.2018-2894
14. Van Reempts PJ, Van Overmeire B, Mahieu LM, Vanacker KJ. Clinical experience with ceftriaxone treatment in the neonate. Chemotherapy. 1995;41(4):316–322.
15. Monte SV, Prescott WA, Johnson KK, et al. Safety of ceftriaxone sodium at extremes of age. Expert Opin Drug Saf. 2008;7(5):515–523.
16. Garrett B. Hile, PharmD; Kaitlin L. Musick, PharmD; Adam J. Dugan, MS; Abby M. Bailey, PharmD; and Gavin T. Howington, PharmD. Occurrence of Hyperbilirubinemia in Neonates Given a Short-term Course of Ceftriaxone versus Cefotaxime for Sepsis. J Pediatr Pharmacol Ther 2021;26(1):99–103.
17. Schlapbach LJ, Aebischer M, Adams M, Natalucci G, Bonhoeffer J, Latzin P. Impact of sepsis on neurodevelopmental outcome in a Swiss National Cohort of extremely premature infants. Pediatrics. 2011;128(2):e348–e57.
18. Naher BS, Mannan MA, Noor K, Shahiddullah M. Role of serum procalcitonin and C-reactive protein in the diagnosis of neonatal sepsis. Bangladesh Medical Research Council bulletin. 2011;37(2):40–6.