PATTERN OF ANTIBIOTICS UTILIZATION IN NEONATAL SEPTICEMIA: A CROSS-SECTIONAL STUDY FROM RURAL TERTIARY CARE HOSPITAL WESTERN MAHARASHTRA, INDIA
DOI:
https://doi.org/10.22159/ijpps.2017v9i3.16210Keywords:
Antibiotic quantification, Empiric antibiotic regimen, Neonates, SepsisAbstract
Objective: To assess the quantification of use of antibiotics and to find out empiric antibiotic regimen practiced for neonatal sepsis in rural tertiary health care centre.
Methods: A hospital, record based cross-sectional study was conducted in Neonatal Intensive Care Unit(NICU) at tertiary care hospital located in western Maharashtra, India. The study was planned during the year 2011-12 among 84 neonates with sepsis. Data were collected by using proforma includes demographic details, antibiotic prescriptions and relevant information.
Results: Among the total 84 neonates, max, 60.71% had a history of term delivery. The proportion of early and late onset of sepsis was 47.61% and 52.38% for which total 18 antibiotics were used of which max, 88.88% were injectables. Amikacin was used in max, 78.57% neonates followed by cefotaxime, 45.23% and ampicillin, 35.71% in single or combination form respectively. Amikacin was used for max; 929 d followed by cefotaxime, 523 d and ampicillin 331 d respectively. Antibiotics used in single, double and multiple regimens were 19.04%, 46.42% and 34.52% respectively. Empiric antibiotic regimens practiced were cefotaxim+amikacin and cefotaxim+ampicillin, of which max, 80% patients were treated with the cefotaxim+amikacin antibiotic regimen. Out of 84 neonates max, 70% were improved at the time of discharge.
Conclusion: Neonatal sepsis was well treated by cefotaxim+amikacin empirical injectable regimen with maximum survival.
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Patel S, Oshodi A, Prasad P, Delamora P, Larson E, Zaoutis T, et al. Antibiotic use in neonatal intensive care units and adherence with centers for disease control and prevention 12 step campaign to prevent antimicrobial resistance. Pediatr Infectious Disease J 2009;28:1047-51.
Clark R, Bloom B, Spitzer A, Gerstmann D. Reported medication use in the neonatal intensive care unit: data from a large national data set. Pediatrics 2006;117:1979-87.
Baker C, Barrett F. Group B streptococcal infections in infants. The importance of various serotypes. JAMA 1974; 230:1158-60.
Karunasekera K, Pathirana D. A preliminary study on neonatal septicemia in a tertiary referral hospital paediatric unit. Ceylon Med J 1999;44:81-6.
Karthikeyan G, Premkumar K. Neonatal sepsis: staphylococcus aureus as the predominant pathogen. Indian J Pediatr 2001;68:715-7.
Rahman S, Hameed A, Roghani M. Multidrug-resistant neonatal sepsis in Peshawar, Pakistan. Arch Disease Childhood Fetal Neonatal 2002;87:49-52.
Bizzarro M, Gallagher P. Antibiotic-resistant organisms in the neonatal intensive care unit. Semin Perinatol 2007;31:26-32.
Cotten C, Taylor S, Stoll B, Goldberg R, Hansen N, Sánchez PJ, et al. Prolonged duration of initial empirical antibiotic treatment is associated with increased rates of necrotizing enterocolitis and death for extremely low birth weight infants. Pediatrics 2009;123:58-66.
Khan D, Khan F, Razzaq A. Therapeutic drug monitoring of amikacin in preterm and term infants. Singapore Med J 2009;50:486-9.
Sherwin C, Svahn S, Van der Linden A, Broadbent R, Medlicott N, Reith D. Individualised dosing of amikacin in neonates: a pharmacokinetic/pharmacodynamic analysis. Eur J Clin Pharmacol 2009;65:705-13.
Alvarez A, Jia Y, Garcia C. Streptococcus bovis bacteremia in neonates in a predominantly hispanic population. Front Pediatr 2015;3:92.
Sengupta M, Banerjee S, Das N. Early onset neonatal septicaemia caused by pantoea agglomerans. J Clin Diagn Res 2016;5:1-2.
Tripathi N, Cotton C, Smith P. Antibiotic use and misuse in the neonatal intensive care unit. Clin Perinatol 2012;39:61-8.
Wiley B. Amikacin-drug uses in pregnancy and the first year of life. Neonatal Formulary 6; 2011. p. 40.
Jiang J, Chui N, Huang F, Kao H, Hsu C, Hung H, et al. Neonatal sepsis in the neonatal intensive care unit: characteristics of early versus late onset. J Microbial Immunol Infect 2004; 37:301-6.
Abdel-Bari A, Mokhtar M, Sabry N, El-Shafi S, Bazan N. Once versus individualized multiple daily dosing of aminoglycosides in critically ill patients. Saudi Pharm 2011;1:9-17.
Awaisu A, Syed A, Mohamed I, Saad A. Antimicrobial’s utilisation and outcomes of neonatal sepsis among patients admitted to a University Teaching Hospital in Malaysia. Eastern J Med 2007;12:6-14.
Jelassi M, Benlmouden A, Lefeuvre S, Mainardi J, Billaud E. Level of evidence For therapeutic drug monitoring of vancomycin. Therapie 2011;66:29-37.
Wiley B. Vancomycin-drug uses in pregnancy and the first year of life: neonatal formulary 6 BMJ Books; 2011. p. 264.
Mahmood A, Karamat K, Butt T. Neonatal sepsis: high antibiotic resistance of the bacterial pathogens in a neonatal intensive care unit in Karachi. J Pak Med Assoc 2002;52:348-50.
Cotten C, McDonald S, Stoll B, Goldberg R, Poole K, Benjamin D. The association of third-generation cephalosporin use and invasive candidiasis in extremely low-birth-weight infants. Pediatrics 2006;118:717-22.
Manzoni P, Farina D, Leonessa M, d'Oulx E, Galletto P, Mostert M, et al. Risk factors for progression to invasive fungal infection in preterm neonates with fungal colonisation. Pediatrics 2006;118:2359-64.
Downie L, Armiento R, Subhi R, Kelly J, Clifford V, Duke T. Community-acquired neonatal and infant sepsis in developing countries: efficacy of WHO's currently recommended antibiotics-systematic review and meta-analysis. Arch Dis Child 2013;98:146-54.
Fernando R, Health P, Menson E. Antimicrobial policies in the neonatal units of the United Kingdom and the republic of Ireland. J Antimicrob Chemother 2008;61:743-5.
Zakariya B, Bhat V, Harish B, Arun Babu T, Joseph N. Neonatal sepsis in a tertiary care hospital in South India: Bacteriological profile and antibiotic sensitivity pattern. Indian J Pediatr 2011;78:413-7.
Dutta S, Reddy R, Sheikh S, Kalra J, Ray P, Narang A. Intrapartum antibiotics and risk factors for early onset sepsis. Arch Dis Child Fetal Neonatal 2010;95:99-103.
Bisht R, Alok A, Singh R, Mittal P. Antibiotic resistance–a global issue of concern. Asian J Pharm Clin Res 2009;2:34-9.
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