Aim. This audit aimed to identify which bacteria were associated with necrotising enterocolitis (NEC) and determine their antibiotic sensitivities. Methods. A retrospective audit of all infants with a diagnosis of suspected NEC or confirmed NEC and a positive culture (blood/faeces/operative specimen or vascular access device) between January 2000 and September 2007 was performed. Results. Ninety nine infants had a diagnosis of suspected (45) or confirmed NEC (54). Seventeen patients had suspected (5) or confirmed (12) NEC and a positive culture result. 12 babies had positive blood cultures associated with their NEC. Only 4 of the 12 cases of NEC with a positive blood culture received adequate first line cover for their subsequently identified infecting organism. Conclusions. Due to the limitations of this study we are unable to make general recommendations on the first line antibiotic choice for babies with suspected or confirmed NEC. Our current regime of Ampicillin, Gentamicin and Metronidazole failed to adequately treat 8 of the 12 organisms subsequently isolated in blood cultures. Only the combination of Vancomycin and Meropenem would have adequately treated all the bacteria identified. The concern with this approach is the possible emergence of multi drug resistant bacteria
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