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Antibiotic prescribing in neonatal intensive care units of two tertiary care hospitals at central India
Sharma et al. Antimicrobial Resistance and Infection Control
Antibiotic prescribing in neonatal intensive care units of two tertiary care hospitals at central India
M Sharma 1 2 3
C Hauge 2 3
J Mandaliya 0 3
G Marrone 2 3
C StålsbyLundborg 2 3
0 Pediatrics, R D Gardi Medical College , Ujjain, Madhya Pradesh , India
1 Pharmacology, R D Gardi Medical College , Ujjain, Madhya Pradesh , India
2 Public Health Sciences , Global Health (IHCAR), KarolinskaInstitutet, Stockholm , Sweden
3 Authors' details
-
From 3rd International Conference on Prevention and Infection Control (ICPIC 2015)
Geneva, Switzerland. 16-19 June 2015
Introduction
Neonates are vulnerable for systemic infections and wise
use of antibiotics is recommended for the group to cut
down the risk of development of antibiotic resistance, a
global threat. There is a general lack of studies that
present antibiotic prescribing practices at neonatal intensive
care units (NICUs) specifically from the countries with
high birth rate such as India.
Objectives
To compare and describe the situation of antibiotic
prescribing at neonatal intensive care units of two private,
tertiary care hospitals of Ujjain district in Central India.
Methods
A cross-sectional study was conducted from 2008 till
2011using customized form. Antibiotics were classified
based on WHO anatomical therapeutic chemical (ATC)
classification and diagnoses were classified using
International Classification of Diseases-10.
Results
Of total 1789 neonates, 1572 were admitted at the NTH
and 217 at the TH. Sepsis was most common diagnosis
in both hospitals (>30%). Antibiotics were prescribed to
higher percentage of neonates with sepsis (NTH-97% and
TH-94%) than to the rest (NTH-89%, TH-71%). Most
frequently prescribed antibiotics for this group were fixed
dose combinations of antibiotics (FDCs, not present in
WHO ATC list, 30%) and 3rd generation cephalosporins
(28%) in the NTH and 3rd generation cephalosporins and
aminoglycosides (36% each) and FDCs (12%) in the TH.
The adherence to the WHO’s model list of essential
medicines and the Indian national list for children were
1Public Health Sciences, Global Health (IHCAR), KarolinskaInstitutet,
Stockholm, Sweden
Full list of author information is available at the end of the article
higher in the teaching hospital than in the non-teaching
hospital, 85% and 50% respectively (p<0.01).
Conclusion
Broad-spectrum antibiotics; including new FDCs were
prescribed in both hospitals but extensively at the NTH.
The adherence to available essential medicines lists was
significantly lower at the NTH. An unnecessary exposure
of neonates with the higher classes of antibiotics might
be seen as a threat for the development of antibiotic
resistance.
There is an urgent need to develop; a diagnoses specific
antibiotic prescribing guidelines for neonates and
measures to reduce the prevalences of infectious diseases
using antibiotic stewardship programs.
Disclosure of interest
None declared.
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