Up to 89% of neonates received antibiotics in cross-sectional Indian study including those with no infections and unclear diagnoses

作者：Hauge Camilla; Lundborg Cecilia Stal**y; Mandaliya Jagdish; Marrone Gaetano; Sharma Megha^*

来源：Acta Paediatrica, 2017, 106(10): 1674-1683.

DOI：10.1111/apa.13935

• Antibiotic prescribing
• Antibiotic resistance
• Neonatal intensive care unit
• Neonatal sepsis
• Teaching hospital

Aim: There is a global lack of data on antibiotic prescribing for neonates. This study compared antibiotic prescribing practices in the neonatal intensive care units (NICUs) of two private-sector, tertiary-level hospitals.
Methods: A three-year, cross-sectional study was conducted from 2008 to 2011 in the NICUs of a teaching and nonteaching hospital in the Ujjain district of India. The data were analysed using methods recommended by the World Health Organization.
Results: Of the 1789 inpatients, 89% (1399/1572) in the nonteaching hospital and 71% (154/217) in the teaching hospital were prescribed antibiotics and 123 patients died. All the antibiotics were prescribed empirically and cephalosporins and aminoglycosides were the most commonly prescribed subclasses. Fixed-dose combinations of cephalosporins were commonly prescribed in the nonteaching hospital. Neonatal sepsis was the most common diagnosis, in more than 30% of patients, and more than 93% neonates with sepsis were prescribed antibiotics. In addition, 40% of neonates in the nonteaching hospital were admitted for observation and were frequently prescribed antibiotics.
Conclusion: These two Indian NICUs prescribed antibiotics for noninfectious or unclear diagnoses in addition to prescribing combinations of broad-spectrum antibiotics. Such practices increase the global risk of treatment failure, neonatal mortality rates and antibiotic resistance.

• 出版日期2017-10