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Updated: Nov 27, 2025

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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Antibiotic Stewardship in Premature Infants: A Systematic Review

Polona Rajar1,2, Ola D Saugstad3, Dag Berild4,5

  • 1Department of Paediatrics, Oslo University Hospital Ullevål, Oslo, Norway.

Neonatology
|December 3, 2020
PubMed

Insights

Antibiotic stewardship programs effectively reduce antibiotic use in premature infants when tailored and multifactorial. Focused strategies on reducing initiation or duration of antibiotic therapy are key for success in neonatal intensive care units.

Area of Science:

  • Neonatal Medicine
  • Infectious Diseases
  • Public Health

Background:

  • Antibiotic overuse in premature infants is common in neonatal intensive care units, leading to serious side effects and potential long-term adverse health outcomes.
  • Antibiotic stewardship programs (ASPs) are a preventive measure to reduce unnecessary antibiotic exposure in vulnerable infant populations.
  • This review focuses on ASPs implemented in premature infants with gestational age ≤34 weeks.

Approach:

  • A systematic literature search was conducted across six major academic databases, adhering to PRISMA guidelines.
  • Twelve studies (11 observational, 1 RCT) met the inclusion criteria after screening 1,212 titles.
  • Articles were critically appraised and grouped by stewardship action: reducing initiation, shortening duration, or organizational implementations.

Key Points:

  • Implemented ASPs demonstrated reductions in antibiotic use among premature newborns.
  • Multifactorial and tailored programs focusing on reducing antibiotic initiation or duration were most effective.
  • Programs lacking specific, targeted measures showed diminished effectiveness.

Conclusions:

  • Antibiotic stewardship programs are effective interventions for premature infants.
  • Tailored, multifactorial ASPs focusing on antibiotic initiation and duration are recommended for neonatal populations.
  • Targeted stewardship strategies are crucial for optimizing antibiotic use and improving outcomes in premature infants.
Abstract

Keywords:
Antibiotic resistanceAntibiotic stewardshipPremature infant

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