‘ Almost no options’ for newborn sepsis

Amanda Davey MULTIPLE recommended regimens for neonatal sepsis are now ineffective in South-East Asia, new data suggest, as researchers sound the alarm over antibiotic-resistant infections in newborns.

A University of Sydney – led study, published in The Lancet Regional Health— Western Pacific, analysed nearly 15,000 blood cultures from infants with suspected sepsis in 10 hospitals across five South- East Asian countries, including

Indonesia and the Philippines.

It revealed“ alarming levels” of antimicrobial resistance, with Gram-negative bacteria responsible for nearly 80 % of neonatal sepsis cases.

“ The predominance of Klebsiella sp., Acinetobacter sp. and Escherichia coli as causative pathogens is consistent with other recent epidemiological data, but the relative contribution of Enterobacter sp. was higher than observed elsewhere,” the researchers wrote.

They said high prevalence of Klebsiella sp. and Acinetobacter sp. was often associated with hospital-acquired infections, suggesting a role for very early horizontal transmission of bacteria in causing neonatal sepsis in these environments.

Study co-author and PhD candidate Michelle Harrison warned that a failure to develop more neonatal-appropriate antimicrobials was leaving doctors with“ almost no effective options” when

resistant organisms emerged in newborns.

“ Australia’ s close ties to South- East Asia and the Western Pacific mean we must stay vigilant,” Ms Harrison said.

“ We need more region-specific surveillance to guide treatment decisions.

“ Otherwise, we risk reversing decades of progress in reducing child mortality rates.”

Lancet Reg Health West Pac 2025; 9 Sep.

Dept says sign up or else!

PAGE 1— declaring,“ We Bulk-Bill Every Eligible Patient.”

It will be mandatory for practices to have signage near their main entrance that is“ visible from 5-10m outside the practice, placed at eye level, not fully or significantly obstructed by any other signage or items” that will“ direct patients through the entrance of the practice”.

The department is also mandating another sign near reception, visible from at least a metre away.

It says the signs cannot be edited, must have clear space around the sides, and that flouting these rules“ may impact a practice and provider’ s eligibility to participate in the bulk-billing Practice Incentives Program”.

Practices are expected to order their signs within 24 hours of signing up and“ must” set up the advertising within five days of receiving it.

They must also sign up to Healthdirect and list their practice as‘ bulk-billing only’, submitting the forms to launch or adjust their listing within 24 hours of registering for the program.

The department says the requirements, laid out in an 11-page booklet, will“ improve awareness of bulk-billing services for patients”.

Example of advertising from the health department’ s guidance.

For her postmenopausal bone health 1

Estrogel helps prevent osteoporosis in women at high risk of fractures 1-3

40 % OF POSTMENOPAUSAL WOMEN WILL EVENTUALLY EXPERIENCE FRACTURES? 4

Menopause is strongly associated with accelerated bone loss, with an increased risk of osteoporotic fractures. 2-3

INDICATIONS: Estrogel is a Hormone Replacement Therapy( HRT) for estrogen deficiency symptoms in postmenopausalwomen and for prevention of osteoporosis in postmenopausal women at high risk of future fractures who are intolerant of, or contraindicated for, other medicinal products approved for the prevention of osteoporosis. 1 Prometrium is for adjunctive use with an estrogen in postmenopausal women with an intact uterus. 5

CONTRAINDICATIONS: Estrogel is contraindicated in women with previous or current VTE and active or recent thromboembolic disease. Estrogel should not be used in women with current or a history of breast cancer. 1 Prometrium is contraindicated in patients with undiagnosed vaginal bleeding; mammary or genital tract carcinoma; thromboembolic disorders; thrombophlebitis and cerebral haemorrhage. 5

SAFETY INFORMATION: Common Estrogel AEs include, but are not limited to, headache, nausea, abdominal pain, breast swelling / pain, and breast enlargement. 1 Common Prometrium AEs include, but are not limited to, altered periods / shortening of the cycle, amenorrhoea, intercurrent bleeding / breakthrough bleeding. 5

A proper risk / benefit analysis should be undertaken for each patient before commencing treatment with Menopausal Hormone Therapy.

PBS Information: EstrogelPro, Estrogel & Prometrium are listed on the PBS. Refer to the PBS for more details.

Please review the Product Information which includes the full indications and safety information before prescribing, accessible at besins-healthcare. com. au / PI or 1800 BESINS( 237 467), or by scanning the QR code:

References: 1. Estrogel ®( estradiol hemihydrate) Product Information, updated 18 December 2023. 2. Palacios S et al. Maturitas 1995; 20:209 – 13. 3. Devogelaer JP et al. Maturitas 1998; 28:243 – 49. 4. Finkelstein JS et al. J Clin Endocrinol Metab 2008; 93( 3): 861 – 68. 5. Prometrium ®( micronised progesterone) Product Information, updated 1 Feb 2022. Estrogel ® and Prometrium ® are registered trademarks of Besins Healthcare. Besins Healthcare Australia Pty Ltd ABN 68 164 882 062. Suite 5.02, 12 Help Street, Chatswood NSW 2067. For medical information call 1800 BESINS( 237 467). www. besins-healthcare. com. au EPR-EST-PRM-2497 July 2025

For her.

Medicine co-pack containing one pack of Estrogel ®( estradiol hemihydrate) plus one pack of Prometrium ®( micronised progesterone) for women with a uterus

Estrogel is indicated for the prevention of osteoporosis in postmenopausal women at high risk of future fractures who are intolerant of, or contraindicated for, other medicinal products approved for the prevention of osteoporosis. 1

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