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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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Profile of antimicrobial use and potential use of the defined daily dose in neonatology

Cinara Rejane Viana Oliveira1,2, Izabel Almeida Alves3, Alfredo Dias de Oliveira-Filho4

  • 1Graduate Program in Pharmaceutical Sciences, Federal University of Sergipe, Avenue Marechal Rondon, Jd. Rosa Elze, São Cristóvão, 49100-000, Sergipe, Brazil. cinararvo@academico.ufs.br.

Scientific Reports
|October 3, 2024
PubMed

Insights

Calculating defined daily doses (DDD) for neonates is crucial for monitoring antimicrobial resistance. This study found neonatal DDDs were significantly lower than adult doses, highlighting the need for neonatology-specific standards.

Area of Science:

  • Neonatal intensive care
  • Infectious disease epidemiology
  • Pharmacology

Background:

  • Monitoring antimicrobial resistance is vital.
  • Standard adult defined daily doses (DDD) are unsuitable for neonates.
  • Neonatal intensive care units (NICUs) require specific antimicrobial use data.

Purpose of the Study:

  • To describe antimicrobial use patterns in a Brazilian NICU.
  • To calculate neonatal defined daily doses (DDD) for antimicrobials.
  • To compare neonatal DDDs with adult DDDs.

Main Methods:

  • Retrospective analysis of medical records from 712 newborns admitted to a NICU.
  • Inclusion of 410 newborns diagnosed with neonatal sepsis.
  • Calculation of antimicrobial use profile and DDDs.

Main Results:

  • Gentamicin and ampicillin were the most frequently used antimicrobials.
  • The combination of ampicillin and gentamicin was most common.
  • Neonatal DDDs were approximately 26 times lower than adult DDDs.
  • Significant differences in DDDs were observed for ampicillin and cefepime compared to adults.

Conclusions:

  • Neonatal DDDs differ substantially from adult DDDs, indicating a need for neonatology-specific standards.
  • Standardizing neonatal DDDs is essential for surveillance and preventing antimicrobial resistance.
  • This study provides crucial data for antimicrobial stewardship in neonatal care.

Keywords:
AntimicrobialsBacterial resistanceDefined daily doseNeonatology

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