Backgroud Antimicrobial are the most commonly prescribed medications in intensive care units. Antimicrobial therapy can alter the neonatal microbiome, making the infant more susceptible to opportunistic infections, and increase incidence of antibiotic-resistant organisms.
Objective To identify the antimicrobial use and appropriateness in our neonatal units and stratify these according to infants’ location and birth weight.
Designethods A single centre prospective observational study in a tertiary care hospital with 40 beds NICU level IIIB and 35 beds level II (ICN).
The patients who received systemic antimicrobial from February to June 2013 were the study subjects. All infants admitted during thesame period were the denominator.
The appropriateness of antimicrobial-use was examined by two independent paediatric infectious disease consultants.
Results 335 neonates received 506 antimicrobial courses, 1080 prescriptions and 4565 antimicrobial days.
Vancomycin, 3rd generation cephalosporins and carbapenems were the most inappropriately used (43%, 24% and 18% of cases respectively).
Conclusion Our results suggest that interventions to improve antimicrobial prescribing in NICU should be implemented at continuation rather than initiation.
Evidence-based guidelines for perioperative prophylaxis should be strictly applied.
Antimirobial use in neonatal units are needed to be monitored regularly.