Improving antibiotic prescribing in neonatal units: time to act

Area of Science:

• Medical Microbiology
• Neonatal Medicine
• Infectious Diseases

Background:

• Antibiotic use is increasing during the peripartum period for maternal and fetal reasons.
• Injudicious antibiotic use contributes to antibiotic resistance, altered gut flora, and immune dysregulation.
• Neonatal units are critical areas for the emergence and spread of multidrug-resistant organisms.

Purpose of the Study:

• To review current antibiotic prescribing practices in the peripartum period.
• To highlight the risks associated with antibiotic resistance and multidrug-resistant organisms in neonatal settings.
• To propose restrictive antibiotic strategies informed by UK neonatal infection surveillance data.

Main Methods:

• Literature review of current practices in peripartum antibiotic use.
• Analysis of epidemiological data from UK neonatal infection surveillance studies.
• Synthesis of findings to inform evidence-based antibiotic stewardship.

Main Results:

• Growing concerns regarding antibiotic resistance and its impact on neonatal health.
• Limited development pipeline for new Gram-negative antibiotics.
• Need for data-driven, restrictive antibiotic strategies in neonatal care.

Conclusions:

• Restrictive antibiotic strategies are crucial for combating resistance in neonatal units.
• Evidence-based approaches using surveillance data can optimize antibiotic use.
• Urgent need for novel antimicrobial agents, especially against Gram-negative bacteria.