Patterns of Antibiotic Indication and Selection in Early-onset Neonatal Infections at a Provincial Obstetrics and Pediatrics Hospital

Abstract

Objective: Subject and method: A cross-sectional study was conducted on patients' medical records who used systemic antibiotics at the Neonatal Department - a provincial Obstetrics and Pediatrics Hospital, from November 2022 to December 2022. Results: The study enrolled 137 patients; mainly full-term infants (78.8%) and adequate birth weight (81.0%). Most cases of suspected neonatal infections were general, with no clear localization (99.3%). The proportion of patients undergoing microbiological testing was low (5.1%). Most patients were indicated appropriate empirical antibiotics (89.1%). The most frequently prescribed initial regimens were monotherapy with ampicillin-sulbactam (54.0%) and a combination of ampicillin/sulbactam and gentamicin (41.6%). The proportion of appropriate initial empiric regimens with the guidelines was 43.8%. 29 patients in this study changed their antibiotic regimen, mainly antimicrobial de-escalation. Conclusion: Most patients in this study were eligible for empirical antibiotics. However, the proportion of choosing monotherapy regimens was quite high, with a rate appropriate to the guidelines of 43.8%. Consider microbiological testing to discontinue antibiotics.