Antibiotic resistance in the NICU

Antimicrobial treatment is a mainstay therapy in the neo-natal intensive care unit (NICU). Given the lack of specificity for clinical symptoms of infection in the newborn and the overwhelming impact of infection with rapid multisystem dissemination, NICU providers tend to treat early while awaiting laboratory results. With the high vulnerability of our special population to a variety of potential infecting microbes, a combination of antibiotics is preferred for initial treatment. The selection of these antibiotics is based on the known or presumed environment of exposure. If the newborn is within a week of birth, we can reasonably expect the likely environment of exposure is the community or the mother. If the newborn is older or has undergone numerous procedures, we can presume the exposure is more likely to be hospital-based.