QUALITATIVE REVIEW OF ANTIBIOTIC USE FOR NEONATAL SEPSIS
DOI:
https://doi.org/10.22159/ijap.2018.v10s1.80Keywords:
Antibiotic, Gyssens, Neonatal sepsisAbstract
Objective: The aim of this study is to evaluate the antibiotic use in neonates with sepsis.
Methods: An observational retrospective study was conducted using medical records of neonates diagnosed with early-/late-onset sepsis who were
prescribed antibiotics and who were treated in the neonatal intensive care unit (NICU) at the Dr. Cipto Mangunkusumo Hospital between January 1 and
December 31, 2015. Patient records were screened for antibiotic use; qualitative analyses were performed using the Gyssens algorithm. Concordance
of empirical antibiotic prescriptions with subsequent blood culture and sensitivity tests was evaluated.
Results: A total of 176 sepsis cases included 80 and 96 neonates with normal and low birth weights (LBWs), respectively. Ampicillinsulbactam+
gentamycin, which is indicated in local guidelines as the first-line antibiotic combination for neonatal sepsis, was most frequently
prescribed. In the normal birth weight group, appropriate antibiotic use (Gyssens Category I) was found in 89.7% of cases, whereas Gyssens Category V
(no indication) was found in 4.54% of cases. In the LBW group, 88.1% and 6.2% of cases were included in Gyssens Categories I and V, respectively.
Only 17.5% and 13.5% cultured blood specimens from normal and LBW groups, respectively, yielded positive results; the most commonly identified
bacteria were Acinetobacter baumannii and Klebsiella pneumonia. All isolates were resistant to ampicillin-sulbactam; only 7.4% were sensitive to
gentamicin.
Conclusion: Antibiotic use for neonatal sepsis in NICU in this study can be considered appropriate, suggesting proper implementation of antimicrobial
guidelines. However, high rates of resistance to the first-line antibiotics for neonatal sepsis are concerning.
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