ASSESSMENT OF THE PATTERN OF ANTIBIOTIC USE IN THE NEONATAL INTENSIVE CARE UNIT (NICU) AT A TERTIARY HOSPITAL IN THE UAE

*Nosaibah Ahmed Al Antali, Ammar Ali Saleh Jaber, Juliana F. Roos, Ammar Abdulrahman Jairoun

ABSTRACT

Background: The use of antibiotics in NICU is considered to be essential either as a Prophylactic or empirical treatment for a number of diseases. Sepsis is considered as one of the major risk diseases and requires a variety of antibiotics. The proper selection of antibiotics is necessary to ensure a successful treatment outcome. Objective: To investigate the proper use of antibiotics. The type of infection, microbiological culture results, empirical and duration of antibiotic, antibiotic-resistant and risk factors associated with sepsis infection in NICU. Methods: This is a retrospective cross-sectional, non-probability study of all newborn babies admitted at NICU at a Tertiary Hospital in the UAE from 1 January 2018 to 31 December 2018. Results: A total of 256 neonates referred to the neonatal intensive care unit. 19 neonates (7.4%) were diagnosed with late-onset Sepsis (LOS), and none of them was diagnosed with early-onset Sepsis (EOS). About 9 neonates (3.5%) were diagnosed with other infections. All-cause infections in the NICU caused by 85.2% of gram-negative bacteria and 29.6% of gram-positive bacteria. There was a high bacterial prevalence of S.Haemolyticus and K.Pneumoniae by (18.5%) in the NICU. Of probable sepsis cases, 170 cases (91.4%) were prescribed Penicillin+Gentamicin.145 cases (78%) were prescribed an empirical antibiotic for ≤ 72 hours. There was a high prevalence of bacterial resistance of K. Pneumoniae and S.Haemolyticus by (18.5%) in the NICU. The central venous line in neonate major risk factor for sepsis as odds ratio 8.88% following by length of stay in NICU 1.03%, Gestational Age 0.82%, and Birthweight 0.23%. Conclusions: Sepsis represents the major reason for neonate morbidity and mortality. Wise choice of antimicrobial agents and optimal duration of treatment in neonatal with the suspected or culture-proven sepsis is critical in order to limit the use of unnecessary wide spectrum antibiotic treatment and to supply local solutions to the worldwide race against antimicrobial resistance.

Keywords: Neonatal Intensive Care Unit, Empirical Antibiotic, Neonatal sepsis, Bacterial resistance.