Antibiotic usage and auditing of antibiotic sensitivity pattern of culture positive neonatal septicemia in neonatal intensive care unit of a tertiary care hospital: a retrospective study

Authors

  • H. N. Nagesh Department of Pharmacology, Mysore Medical College and Research Institute, Mysore, Karnataka, India
  • P. L. Basavanna Department of Pharmacology, Mysore Medical College and Research Institute, Mysore, Karnataka, India
  • M. R. Savitha Department of Paediatrics, Mysore Medical College and Research Institute, Mysore, Karnataka, India

Keywords:

Neonatal sepsis, Antibiotic sensitivity and resistance, Empirical antibiotics, Combination therapy

Abstract

Background: Antibiotic resistance is an emerging problem in neonatal intensive care units (NICU) particularly in developing countries. The spectrum of organisms that cause neonatal sepsis changes from time to time and varies from region to region. Hence continuous surveillance for antibiotic susceptibility, rational use of antibiotics and the strategy of antibiotic cycling can provide some answers to it. the present study was undertaken to study the various antibiotics used and to analyze the antibiotic sensitivity and resistance pattern in NICU of tertiary care hospital.

Methods: The clinical files of neonates admitted in the NICU of Cheluvamba Hospital, Mysore from April to September 2012 were revised. The diagnosis, antibiotics used, culture and sensitivity were collected. The data were analyzed using SPSS version 17.0.

Results: A total of 185 blood culture positive reports were analyzed. Most commonly used empirical antibiotic was amikacin (96.2%) followed by cefotaxime (57.3%) and piperacillin-tazobactam (28.1%). Commonly used combination antibiotics were amikacin and cefotaxime (58.6%), followed by amikacin and piperacillin-tazobactam (28.7%). Rarely vancomycin (3.8%) or meropenem (1.7%) were used as first-line antibiotics in severe sepsis. Piperacillin-tazobactam (21.6%) followed by vancomycin (19.5%) were commonly used as second line drugs. Organisms showed maximum resistance against penicillins (91.7%), ceftazidime (96.9%), cefotaxime (85.3%), cefoxitin (75.6%), ceftriaxone (72.4%) and amikacin (55%) and maximum sensitivity to vancomycin (100%), linezolid (100%), imipenem (92.3%), netilmicin (60%) and piperacillin-tazobactum (52.4%).

Conclusions: (1) There is an emerging resistance against cephalosporins (including 3rd generation) and amikacin, (2) vancomycin, linezolid, imipenem are showing maximum sensitivity and hence should be kept in reserve for resistant cases.

References

Aftab R, Iqbal I. Bacteriological agents of neonatal sepsis in NICU at Nishtar Hospital Multan. J Coll Physicians Surg Pak. 2006;16(3):216-9.

Shitaye D, Asrat D, Woldeamanuel Y, Worku B. Risk factors and etiology of neonatal sepsis in Tikur Anbessa University Hospital, Ethiopia. Ethiop Med J. 2010;48(1):11-21.

Kaistha N, Mehta M, Singla N, Garg R, Chander J. Neonatal septicemia isolates and resistance patterns in a tertiary care hospital of North India. J Infect Dev Ctries. 2009;4(1):55-7.

Mahmood A, Karamat KA, Butt T. Neonatal sepsis: High antibiotic resistance of the bacterial pathogens in a neonatal intensive care unit in Karachi. J Pak Med Assoc. 2002;52(8):348-50.

Yurdakök M. Antibiotic use in neonatal sepsis. Turk J Pediatr. 1998;40(1):17-33.

Shahian M, Pishva N, Kalani M. Bacterial etiology and antibiotic sensitivity patterns of early – Late onset neonatal sepsis among newborns in Shiraz, Iran 2004-2007. Int J Mater Sci Res. 2010;35:293-8.

Shrestha S, Adhikari N, Rai BK, Shreepaili A. Antibiotic resistance pattern of bacterial isolates in neonatal care unit. JNMA J Nepal Med Assoc. 2010;50(180):277-81.

Marzban A, Samaee H, Mosavinasab N. Changing trend of empirical antibiotic regimen: Experience of two studies at different periods in a neonatal intensive care unit in Tehran, Iran. Acta Med Iran. 2010;48(5):312-5.

Shaw CK, Shaw P, Thapalial A. Neonatal sepsis bacterial isolates and antibiotic susceptibility patterns at a NICU in a tertiary care hospital in western Nepal: A retrospective analysis. Kathmandu Univ Med J (KUMJ). 2007;5(2):153-60.

Kairavi JD, Saklainhaider SM. Neonatal septicemia: Bacterial isolates and their antibiotics susceptibility patterns. Natl J Integr Res Med. 2010;1:12-5.

Anwer SK, Mustafa S, Pariyani S, Ashraf S, Taufiq KM. Neonatal sepsis: An etiological study. J Pak Med Assoc. 2000;50(3):91-4.

Kaushal VS, Tejas KP, Tripathi CB. Antibiotic sensitivity pattern in neonatal intensive care unit of a tertiary care hospital of India. Asian J Pharm Clin Res. 2012;5(3):46-50.

Reese HC, Alan RS. Antibiotics used in the NICU - From the pediatrix-obstetrix cener for research and education. Neonatol Today. 2006;1(5):1-9.

Schellack N, Gous AGS. Antibiotic prescribing patterns in a neonatal ICU, Part II. South Afr J Epidemiol Infect. 2011;26(4):267-70.

Movahedian AH, Moniri R, Mosayebi Z. Bacterial culture of neonatal sepsis. Iran J Public Health. 2006;35:84-9.

Aurangzeb B, Hameed A. Neonatal sepsis in hospital-born babies: Bacterial isolates and antibiotic susceptibility patterns. J Coll Physicians Surg Pak. 2003;13(11):629-32.

Downloads

Published

2017-02-07

Issue

Section

Original Research Articles