Audit to optimize antibiotics use in neonatal septicemia

Area of Science:

• Clinical Microbiology
• Neonatal Care
• Infectious Diseases

Background:

• Neonatal sepsis poses a significant threat to infant survival globally.
• Inappropriate antibiotic use contributes to antimicrobial resistance and poor clinical outcomes.
• Limited local data on antibiotic resistance patterns complicates effective treatment strategies.

Purpose of the Study:

• To evaluate the appropriateness of antibiotic prescribing for neonatal sepsis.
• To identify areas for improvement in antibiotic selection, dosage, and frequency.
• To underscore the necessity of establishing local antibiotic stewardship programs.

Main Methods:

• A clinical audit was performed in a tertiary care hospital's neonatal ward over one year.
• Blood culture and drug susceptibility reports were collected and analyzed.
• Clinical records were reviewed for antibiotic choice, dosage, frequency, and patient outcomes.

Main Results:

• Eighty-five neonates with sepsis received empirical antibiotic therapy, often in combination (e.g., Cefotaxime and Amikacin).
• Optimal antibiotic dosing was achieved in only 70.2% of cases.
• Gram-negative bacilli were the predominant isolates (81.2%), with Imipenem, Piperacillin-Tazobactam, and Gentamicin showing higher susceptibility.

Conclusions:

• Inconsistent antibiotic use in neonatal sepsis is linked to poor outcomes and rising antimicrobial resistance.
• There is a critical need for local antibacterial susceptibility data and pediatrician education on antibiotic protocols.
• Implementing antibiotic stewardship programs is essential to optimize antibiotic use and improve neonatal health indicators.