Evaluation of antibiotic prescriptions for sepsis in the Neonatal Intensive Care Unit in a Tertiary Hospital in North Sumatera, Indonesia

Abstract

Background. Neonatal sepsis is a leading cause of morbidity and mortality worldwide. The evaluation of antibiotic prescription in neonatal intensive care units (NICUs) is important for reducing inappropriate antibiotic use and minimizing the development of antibiotic resistance. Antimicrobial stewardship programs potentially promote a prudent use of antibiotics; however, the approach in NICUs is not yet optimal. Objectives. The aim of our study was to evaluate antibiotic prescriptions for neonatal sepsis in a tertiary hospital in North Sumatera, indonesia. Material and methods. In our retrospective study, we collected data from medical records and enrolled 324 neonatal sepsis patients who received one or more antibiotics. Results. Gentamycin and cefotaxime were the two most common antibiotics prescribed in the NICU (72.22% and 71.60%, respectively). However, high levels of resistance to gentamycin and cefotaxime were found among common pathogens circulating in the NICU (55.56% and 82.81%, respectively). Only 40.33% of the antibiotic prescriptions were appropriate: approximately 15.11% of the patients had received antibiotics with incorrect indications and 16.16% of the antibiotics had been administered without sufficient duration. Conclusions. The appropriate use of antibiotic prescriptions in the NICU was low, which may lead to high mortality in neonatal sepsis patients. Continued evaluation of antibiotic usage by implementing antimicrobial stewardship programs in the NICU is important.

Evaluation of potentially inappropriate prescribing and deprescription as elements of good medical practice in elderly patient care

“…Such drugs should thus be withdrawn as soon as possible, and their administration should be immediately discontinued if it is found that they were introduced into the treatment without proper indication [71], especially when there is a dominance of viral infections [72]. on the other hand, justified antibiotic treatment must also not be discontinued too early [73].…”

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“…Microbial resistance to antimicrobials has become a global problem, with various detrimental impacts that can reduce the quality of health services. The emergence and development of resistant microbes occurs due to selection pressures associated with the use of antibiotics [2].…”