Antibiotic Prescription Pattern for Neonatal Sepsis at the University College Hospital, Ibadan; How Judicious

Olukemi Oluwatoyin Tongo; Adeyemi Adeyinka Labaeka

doi:doi:10.11648/j.ajp.20200601.20

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Antibiotic Prescription Pattern for Neonatal Sepsis at the University College Hospital, Ibadan; How Judicious

Olukemi Oluwatoyin Tongo, Adeyemi Adeyinka Labaeka

Published in American Journal of Pediatrics (Volume 6, Issue 1)

Received: 3 February 2020 Accepted: 14 February 2020 Published: 26 February 2020

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Abstract

Multidrug-resistant bacterial infection is a global phenomenon and newborn units are not spared. Judicious use of antibiotics is one of the measures employed to curb the emergence of multidrug-resistant bacteria. It entails the use of empiric antibiotics based on knowledge of prevailing pathogens and antibiotic susceptibility patterns while awaiting the results of cultures. This retrospective review of records of 170 outborn neonates treated at the emergency room of the University College Hospital (UCH), Ibadan sought to determine indications for antibiotic therapy, the available supporting investigations and factors militating against the judicious use of antibiotics in newborns. The median age at presentation was three days. The majority (91.2%) were commenced on antibiotics on admission without any prior laboratory investigations. The indications for antibiotics were based on clinical signs only in 48% of cases, risk factors for sepsis with clinical signs in 42% of cases and no apparent reason in 6.8%. Lack of funds and logistic problems with the laboratory were the reasons for not conducting investigations before the commencement of antibiotics in 49.4% and 15.3% of cases respectively. Full blood count was eventually done in 32.9% of which a third were consistent with sepsis. Blood cultures were eventually done in 33.5% and positive in 5.3% of cases. Majority of newborns had empiric antibiotic therapy without the necessary laboratory back up due largely to financial constraints and other logistic issues with the laboratory. Inappropriate use of antibiotics in terms of initiation of empiric treatment, choice of drugs and failure to investigate as necessary was common.

Published in	American Journal of Pediatrics (Volume 6, Issue 1)
DOI	10.11648/j.ajp.20200601.20
Page(s)	58-61
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Neonatal Sepsis, Judicious, Rational Antibiotics

References

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[4]	Klinger G, Levy I, Sirota L, et al. Outcome of early-onset sepsis in a national cohort of very-low-birth-weight infants. Pediatrics. 2010; 125 (4): e736–e740.
[5]	Clark RH, Bloom BT, Spitzer AR, et al. Reported medication use in the neonatal intensive care unit: data from a large national data set. Pediatrics. 2006; 117 (6): 1979–1987.
[6]	Tripathi N, Cotton CM, Smith PB. Antibiotic use and misuse in the Neonatal Intensive Care Unit. Clinics in Perinatology 2012; 39 (1): 61-68.
[7]	Carlet J, Rambaud C and Pulcini C. Save Antibiotics: a call for action of the World Alliance Against Antibiotic Resistance (WAAAR). BMC Infectious Diseases. 2014, 14: 436 available at http://www.biomedcentral.com/1471-2334/14/436.
[8]	Piddock L J: The crisis of no new antibiotics-what is the way forward. Lancet Infect Dis 2012, 12: 24953.
[9]	Ball P1, Baquero F, Cars O, File T, Garau J, et al. Antibiotic therapy of community respiratory tract infections: strategies for optimal outcomes and minimized resistance emergence. Journal of Antimicrobial Chemotherapy 2002; 49: 31–40.
[10]	Society for Healthcare Epidemiology of America, Infectious Diseases Society of America, Pediatric Infectious Diseases Society. Policy statement on antimicrobial stewardship. Infect Control Hosp Epidemiol 2012; 33 (4): 322–327.
[11]	Dellit JH, Owens RC, Jr McGowan JE, Gerding DN, Weinstein RA, Burke JP, Hushing WC, Paterson DL, Fishman NO, Carpenter CF, Brennan PJ, Billeter M, Hooton TM. Infectious diseases society of America and society of health care epidemiology of America guidelines for developing an institutional program to enhance antibiotic stewardship. Clin Infect Dis 2007, 44: 159–77.
[12]	Ting JY, Synnes A, Roberts A, Deshpandey A, Dow K, Yoon EW, Lee KS, Dobson S, Lee SK, Shah PS; Canadian Neonatal Network Investigators. Association Between Antibiotic Use and Neonatal Mortality and Morbidities in Very Low-Birth-Weight Infants Without Culture-Proven Sepsis or Necrotizing Enterocolitis. JAMA Pediatr. 2016; 170 (12): 1181-1187.
[13]	Aregbeshola BS. Out-of-pocket payments in Nigeria. The Lancet 2016; 387 (10037): 2506.
[14]	Tongo O O., Orimadegun A E, Ajayi S O, Akinyinka O O. (2009) The Economic Burden of Preterm/Very Low Birth Weight Care in Nigeria. Journal of Tropical Paediatrics. Vol. 55. No. 4. 262–264.
[15]	Patel SJ, 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 Infect Dis J. 2009 Dec; 28 (12): 1047–1051.
[16]	Levy ER, Swami S, Dubois SG, Wendt R, Banerjee R. Rates and appropriateness of antimicrobial prescribing at an academic children’s hospital, 2007–2010. Infect Control Hosp Epidemiol 2012; 33 (4): 346–353.
[17]	Daniel M. Keller. Antibiotic Overuse Reduced Without Restricting Availability. Abstract presented at 51st Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC): September 17, 2011.
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Olukemi Oluwatoyin Tongo, Adeyemi Adeyinka Labaeka. (2020). Antibiotic Prescription Pattern for Neonatal Sepsis at the University College Hospital, Ibadan; How Judicious. American Journal of Pediatrics, 6(1), 58-61. https://doi.org/10.11648/j.ajp.20200601.20

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Olukemi Oluwatoyin Tongo; Adeyemi Adeyinka Labaeka. Antibiotic Prescription Pattern for Neonatal Sepsis at the University College Hospital, Ibadan; How Judicious. Am. J. Pediatr. 2020, 6(1), 58-61. doi: 10.11648/j.ajp.20200601.20

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AMA Style

Olukemi Oluwatoyin Tongo, Adeyemi Adeyinka Labaeka. Antibiotic Prescription Pattern for Neonatal Sepsis at the University College Hospital, Ibadan; How Judicious. Am J Pediatr. 2020;6(1):58-61. doi: 10.11648/j.ajp.20200601.20

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@article{10.11648/j.ajp.20200601.20,
  author = {Olukemi Oluwatoyin Tongo and Adeyemi Adeyinka Labaeka},
  title = {Antibiotic Prescription Pattern for Neonatal Sepsis at the University College Hospital, Ibadan; How Judicious},
  journal = {American Journal of Pediatrics},
  volume = {6},
  number = {1},
  pages = {58-61},
  doi = {10.11648/j.ajp.20200601.20},
  url = {https://doi.org/10.11648/j.ajp.20200601.20},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20200601.20},
  abstract = {Multidrug-resistant bacterial infection is a global phenomenon and newborn units are not spared. Judicious use of antibiotics is one of the measures employed to curb the emergence of multidrug-resistant bacteria. It entails the use of empiric antibiotics based on knowledge of prevailing pathogens and antibiotic susceptibility patterns while awaiting the results of cultures. This retrospective review of records of 170 outborn neonates treated at the emergency room of the University College Hospital (UCH), Ibadan sought to determine indications for antibiotic therapy, the available supporting investigations and factors militating against the judicious use of antibiotics in newborns. The median age at presentation was three days. The majority (91.2%) were commenced on antibiotics on admission without any prior laboratory investigations. The indications for antibiotics were based on clinical signs only in 48% of cases, risk factors for sepsis with clinical signs in 42% of cases and no apparent reason in 6.8%. Lack of funds and logistic problems with the laboratory were the reasons for not conducting investigations before the commencement of antibiotics in 49.4% and 15.3% of cases respectively. Full blood count was eventually done in 32.9% of which a third were consistent with sepsis. Blood cultures were eventually done in 33.5% and positive in 5.3% of cases. Majority of newborns had empiric antibiotic therapy without the necessary laboratory back up due largely to financial constraints and other logistic issues with the laboratory. Inappropriate use of antibiotics in terms of initiation of empiric treatment, choice of drugs and failure to investigate as necessary was common.},
 year = {2020}
}

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TY - JOUR
T1 - Antibiotic Prescription Pattern for Neonatal Sepsis at the University College Hospital, Ibadan; How Judicious
AU - Olukemi Oluwatoyin Tongo
AU - Adeyemi Adeyinka Labaeka
Y1 - 2020/02/26
PY - 2020
N1 - https://doi.org/10.11648/j.ajp.20200601.20
DO - 10.11648/j.ajp.20200601.20
T2 - American Journal of Pediatrics
JF - American Journal of Pediatrics
JO - American Journal of Pediatrics
SP - 58
EP - 61
PB - Science Publishing Group
SN - 2472-0909
UR - https://doi.org/10.11648/j.ajp.20200601.20
AB - Multidrug-resistant bacterial infection is a global phenomenon and newborn units are not spared. Judicious use of antibiotics is one of the measures employed to curb the emergence of multidrug-resistant bacteria. It entails the use of empiric antibiotics based on knowledge of prevailing pathogens and antibiotic susceptibility patterns while awaiting the results of cultures. This retrospective review of records of 170 outborn neonates treated at the emergency room of the University College Hospital (UCH), Ibadan sought to determine indications for antibiotic therapy, the available supporting investigations and factors militating against the judicious use of antibiotics in newborns. The median age at presentation was three days. The majority (91.2%) were commenced on antibiotics on admission without any prior laboratory investigations. The indications for antibiotics were based on clinical signs only in 48% of cases, risk factors for sepsis with clinical signs in 42% of cases and no apparent reason in 6.8%. Lack of funds and logistic problems with the laboratory were the reasons for not conducting investigations before the commencement of antibiotics in 49.4% and 15.3% of cases respectively. Full blood count was eventually done in 32.9% of which a third were consistent with sepsis. Blood cultures were eventually done in 33.5% and positive in 5.3% of cases. Majority of newborns had empiric antibiotic therapy without the necessary laboratory back up due largely to financial constraints and other logistic issues with the laboratory. Inappropriate use of antibiotics in terms of initiation of empiric treatment, choice of drugs and failure to investigate as necessary was common.
VL - 6
IS - 1
ER -

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Author Information

Olukemi Oluwatoyin Tongo

Department of Pediatrics, University of Ibadan, Ibadan, Nigeria
Adeyemi Adeyinka Labaeka

Department of Pediatrics, University College Hospital, Ibadan, Nigeria

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APA Style

Olukemi Oluwatoyin Tongo, Adeyemi Adeyinka Labaeka. (2020). Antibiotic Prescription Pattern for Neonatal Sepsis at the University College Hospital, Ibadan; How Judicious. American Journal of Pediatrics, 6(1), 58-61. https://doi.org/10.11648/j.ajp.20200601.20

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ACS Style

Olukemi Oluwatoyin Tongo; Adeyemi Adeyinka Labaeka. Antibiotic Prescription Pattern for Neonatal Sepsis at the University College Hospital, Ibadan; How Judicious. Am. J. Pediatr. 2020, 6(1), 58-61. doi: 10.11648/j.ajp.20200601.20

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AMA Style

Olukemi Oluwatoyin Tongo, Adeyemi Adeyinka Labaeka. Antibiotic Prescription Pattern for Neonatal Sepsis at the University College Hospital, Ibadan; How Judicious. Am J Pediatr. 2020;6(1):58-61. doi: 10.11648/j.ajp.20200601.20

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@article{10.11648/j.ajp.20200601.20,
  author = {Olukemi Oluwatoyin Tongo and Adeyemi Adeyinka Labaeka},
  title = {Antibiotic Prescription Pattern for Neonatal Sepsis at the University College Hospital, Ibadan; How Judicious},
  journal = {American Journal of Pediatrics},
  volume = {6},
  number = {1},
  pages = {58-61},
  doi = {10.11648/j.ajp.20200601.20},
  url = {https://doi.org/10.11648/j.ajp.20200601.20},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20200601.20},
  abstract = {Multidrug-resistant bacterial infection is a global phenomenon and newborn units are not spared. Judicious use of antibiotics is one of the measures employed to curb the emergence of multidrug-resistant bacteria. It entails the use of empiric antibiotics based on knowledge of prevailing pathogens and antibiotic susceptibility patterns while awaiting the results of cultures. This retrospective review of records of 170 outborn neonates treated at the emergency room of the University College Hospital (UCH), Ibadan sought to determine indications for antibiotic therapy, the available supporting investigations and factors militating against the judicious use of antibiotics in newborns. The median age at presentation was three days. The majority (91.2%) were commenced on antibiotics on admission without any prior laboratory investigations. The indications for antibiotics were based on clinical signs only in 48% of cases, risk factors for sepsis with clinical signs in 42% of cases and no apparent reason in 6.8%. Lack of funds and logistic problems with the laboratory were the reasons for not conducting investigations before the commencement of antibiotics in 49.4% and 15.3% of cases respectively. Full blood count was eventually done in 32.9% of which a third were consistent with sepsis. Blood cultures were eventually done in 33.5% and positive in 5.3% of cases. Majority of newborns had empiric antibiotic therapy without the necessary laboratory back up due largely to financial constraints and other logistic issues with the laboratory. Inappropriate use of antibiotics in terms of initiation of empiric treatment, choice of drugs and failure to investigate as necessary was common.},
 year = {2020}
}

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