Prescribing pattern of antibiotics in neonates in a tertiary care hospital in south india

Background: Antibiotics are the most frequently used medicines in Neonatal Intensive Care Unit (NICU). It is essential to have detailed information regarding the quantitative and qualitative use of antibiotics to device approaches for decreasing the overuse and misuse of antibiotics and also to deal with the risk caused by resistant pathogens. Objective: To assess the current prescribing pattern of antibiotics in neonatal intensive care unit (NICU) of tertiary care hospital in South India and to assess the antimicrobial susceptibility pattern. Methodology: A prospective observational study was conducted for six months from November 2013 to April 2014 in NICU of tertiary care hospital of south India, after taking the ethical committee approval (IEC 614/2013). 122 neonates were selected who are on antibiotics. Relevant data was collected in the case record form and analyzed using SPSS 20. Results: Out of 404 neonates, 122 patients who were prescribed antibiotics, 51 (41.8%) patients were diagnosed with a specificinfection and the remaining 58.2% were treated empirically. Sepsis – 25 (20.5%) was the most prevalent infection. Coagulase negative Staphylococcus sp. (26.3%) was most commonly isolated organism followed by Enterobacter sp. (21.1%). 46.7% prescriptions contained two antibiotics and also it showed better outcome. Amikacin (91.8%) and ampicillin (63.9%) were the most prescribed antibiotics. 80% of the antibiotics were administered for ten days or longer. Vancomycin was prescribed for a maximum of 30 days followed by cefotaxime for 26 days and ciprofloxacin, ceftazidime, cefuroxime consecutively for 25 days. Amino glycosides (97.54%) were the most prescribed antibiotic class. Coagulase negative Staphylococcus species were sensitive to amikacin, ampicillin/amoxicillin, vancomycin, linezolid, teicoplanin (100%) and cotrimoxazole. Conclusion: Outcome of this study would be useful potentially in designing strategies both at the level of physicians and the administrators for rational prescribing of antibiotics and policy decisions respectively.