The percentage of babies in Sweden who receive antibiotics to treat suspected sepsis varies significantly by region, according to a recent study from the University of Gothenburg. In addition to emphasising areas that exhibit outstanding practices, the researchers hope to raise awareness of the problem of overprescribing.

The main reason antibiotics are given to infants is to treat suspected sepsis, a dangerous illness that needs to be treated right away. Even while sepsis occurrences have been progressively declining over time, a recent study raised concerns regarding disproportionately high use among infants, despite Sweden ranking low internationally in terms of overall antibiotic use.

Nationwide Data Across Major Regions and Hospitals

This recent study used data from 37 hospitals with neonatal care units to examine antibiotic use among babies in six important regions of Sweden. Over a million babies born between 2012 and 2020—all of whom were delivered at or after 34 weeks of gestation—were assessed for this study. The Archives of Disease in Childhood: Foetal & Neonatal Edition reported the findings.

Varying Treatment Rates

The researchers examined how many newborns received antibiotics within their first week of life—a key metric in neonatal care. In countries like Sweden, where sepsis rates are already low, the target is to keep treatment rates under one percent without compromising outcomes.

However, regional differences were marked. Western Sweden reported the highest rate of antibiotic administration at 3.0%, followed by northern (2.2%), south-eastern (2.1%), southern (1.7%), central (1.6%), and eastern Sweden, which had the lowest at 1.3%. Across all regions, actual sepsis cases remained low, under one per 1,000 live births.

At the individual hospital level, the use of antibiotics varied from as low as 0.9% to as high as 4.3%.

Local Practices Play a Role

Johan Gyllensvärd, a pediatrician and PhD student at the Sahlgrenska Academy, University of Gothenburg, helped lead the study. He emphasized that differing local approaches contribute significantly to the variation in antibiotic use.

“The threshold for antibiotic intervention varies, explained in part by prevalence levels, but it’s also down to local practices. It’s very much a matter of the policies and traditions seen at the different hospitals,” he says.

While sepsis is a critical condition that demands swift treatment, overuse of antibiotics in infants can disrupt the delicate balance of their gut microbiota and increase the risk of resistance to antibiotics in the future.

“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. 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,” Johan Gyllensvärd explains.

Antibiotic Use by Region and Hospital

Newborns treated with antibiotics during their first week of life (%):

By Region:

• Western Sweden: 3.0% (e.g., Gothenburg, Borås, Trollhättan)
• Northern Sweden: 2.2% (e.g., Umeå, Luleå, Sundsvall)
• South-eastern Sweden: 2.1% (e.g., Linköping, Jönköping)
• Southern Sweden: 1.7% (e.g., Malmö, Lund)
• Central Sweden: 1.6% (e.g., Uppsala, Karlstad)
• Eastern Sweden: 1.3% (e.g., Huddinge, Visby)
  

By Hospital:

• Lowest rates:
  
  • Västerås: 0.9%
  • Örebro: 1.0%
  • Södersjukhuset: 1.0%
  • Visby: 1.1%
  • Norrköping: 1.2%
    
• Highest rates:
  
  • Luleå: 2.6%
  • Umeå: 2.6%
  • Skövde: 2.9%
  • Borås: 3.7%
  • Trollhättan: 4.3%
    

Sources: University of Gothenburg, Swedish Medical Birth Register, Swedish Neonatal Quality Register

Original Publication
Authors: Johan Gyllensvärd, Marie Studahl, Lars Gustavsson, Elisabet Hentz, Karin Åkesson, Huiqi Li, Mikael Norman and Anders Elfvin.
Journal: Archives of Disease in Childhood – Fetal and Neonatal Edition
DOI: 10.1136/archdischild-2025-328944
Method of Research: Observational study
Subject of Research: People
Article Title: Variations in antibiotic use in late preterm and term newborns from 2012 to 2020: a nationwide population-based observational study
Article Publication Date: 18-Jul-2025