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PO-0551 An Audit Of Antibiotic Use For Early Onset Neonatal Infection In A Northern Irish District General Hospital
  1. L McDowell,
  2. N Geoghegan,
  3. M Hogan,
  4. J Henderson
  1. Paediatrics, Craigavon Area Hospital, Portadown, UK

Abstract

Background Early onset neonatal sepsis is a significant cause of morbidity and mortality. The decision to treat has consequences and a balance must be reached between identifying sick babies and avoiding the potential hazards associated with investigations and over-treatment. Using the 2012 National Institute of Clinical Excellence (NICE) guideline we aimed to identify neonates at risk of sepsis and initiate treatment early. The purpose of the audit was to assess Craigavon Area Hospital’s adherence to this guideline.

Methodology All neonates who were commenced on antibiotics within the first 72 h of life between 9th–28th September 2013 were identified. A re-audit was carried out between 5th–19th January 2014. 17 patients were included in the first audit and 15 in the second cycle. Clinical notes were retrospectively analysed by two investigators. The NICE audit tool was used to examine domains including; time taken to commence treatment, use of the correct dose regime of appropriate antibiotics, appropriate blood tests and prompt action on results. As a result of the first audit cycle a checklist was developed highlighting risk factors for sepsis and NICE guidelines. This was included in medical notes as a prompt for junior doctors. The re-audit evaluated for improved performance.

Results and conclusions Overall the unit adhered well to the guideline. Areas for improvement included; availability of culture results within 36 h and repeat of inflammatory markers 18–24 h after commencing antibiotics. Introduction of the checklist improved observation of NICE guidelines overall although availability of culture results remained problematic.

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