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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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Antibiotics Prescriptions in the Neonatal Intensive Care Unit: How to Overcome Everyday Challenges

D Donà1, E Mozzo1, V Mardegan2

  • 1Division of Pediatric Infectious Diseases, Department for Woman and Child Health, University of Padua, Padua, Italy.

American Journal of Perinatology
|April 11, 2017
PubMed

Insights

Antimicrobial stewardship programs (ASPs) in neonatal intensive care units (NICUs) are crucial for preventing multidrug-resistant organisms (MDROs) and reducing antibiotic-related harm. Effective ASPs involve multidisciplinary collaboration and specific strategies to optimize antibiotic use.

Area of Science:

  • Neonatal Medicine
  • Infectious Diseases
  • Pharmacology

Background:

  • Antimicrobial use in neonatal intensive care units (NICUs) contributes to multidrug-resistant organisms (MDROs) and patient morbidity.
  • Prolonged antibiotic exposure in neonates is linked to adverse outcomes like invasive candidiasis, necrotizing enterocolitis, and late-onset sepsis.

Purpose of the Study:

  • To review challenges in antimicrobial prescribing within NICUs.
  • To present evidence-based solutions and strategies for antimicrobial stewardship programs (ASPs).

Main Methods:

  • Literature review of antimicrobial stewardship strategies in NICU settings.
  • Discussion of multidisciplinary collaboration essential for robust ASPs.
  • Highlighting key ASP interventions such as specimen management, narrow-spectrum prescribing, and de-escalation.

Main Results:

  • Antimicrobial stewardship programs (ASPs) are effective in preventing resistance and optimizing clinical outcomes.
  • Multidisciplinary teamwork is fundamental for successful ASP implementation.
  • Specific strategies like education, clinical pathways, prospective audits, and formulary restrictions are vital.

Conclusions:

  • Implementing comprehensive ASPs in NICUs is essential for combating antimicrobial resistance.
  • Optimizing antibiotic prescribing through ASPs improves patient outcomes and reduces associated morbidities.
  • A collaborative, multifaceted approach is key to successful antimicrobial stewardship in neonates.

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