“Use Judiciously, or I Will Be Useless” A Clinical Audit on Use of Antibiotics Within First 72 hrs of Life in Symptomatic Term Babies With no Maternal Risk for Infection
Journal Title: Progressing Aspects in Pediatrics and Neonatology - Year 2018, Vol 2, Issue 1
Abstract
Over use of antibiotics lead to resistance and unwanted sideeffects in newborns. Since 1992, professional societies or public health agencies have issued several generations of recommendations for prevention or management of early-onset neonatal sepsis (EOS) [1-5]. Despite these efforts, recommendations remain inconsistent, clarifications are necessary, local adaptations are common, and compliance rates are low [6-7]. It is common clinical practice to discontinue antibiotic treatment of asymptomatic babies if the blood cultures are negative at 48 hours [8-10]. But it is very common to have prolonged antibiotic courses for more than 48 hours due to delayed release of blood culture, high CRP, abnormal CBC or delayed decision by the Physician to stop antibiotics. In a previous study, McDonald et al. [11] found this as a common occurrence in neonatal intensive care units. The purpose of this audit is to rationalize the use of antibiotics in symptomatic term babies, with no risk for infection.This is a retrospective audit to determine the Use of antibiotics in symptomatic term babies with no maternal risk for infection. Any full-term infant who was started on antibiotics after admitting to NICU with various symptoms were included. Preterm babies and babies with maternal risk for infection (i.e. suspected maternal chorioamnionitis, PROM >18 hrs, GBS bacteriuria in mother) were excluded from the audit. Data were collected from January to March 2017 and analyzed with descriptive statistics. A re-audit was carried out between January to March 2018. 35 patients were included in the first audit and 22 in the second cycle. As a result of the first audit cycle following changes in practice were implemented.
Authors and Affiliations
Khalil Salameh, Abedal khalik Ahmad Khedr, Rajesh Pattu Valappil, Ahmed Hosny Ahmed Tomerak
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