Pattern of antibiotic use in neonatal intensive care unit in tertiary care hospital in Southern India

Authors

  • Anjali Ravindra Shinde Department of Pharmacology, Prakash Institute of Medical Sciences Urun-Islampur, Mahatashtra, India
  • Jaydeep M. Bairagi Drug Safety Physician, Cognizant Technology Solutions Pune, Maharashtra, India
  • Chitra C. Khanwelkar Department of Pharmacology,Krishna Institute of Medical Sciences, Karad, Maharashtra, India
  • Ravindra Vasantrao Shinde Department of Microbiology,Krishna Institute of Medical Sciences, Karad, Maharashtra, India
  • Rajsinh Vishwasrao Mohite Department of Community Medicine, Krishna Institute of Medical Sciences, Karad, Maharashtra, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20162473

Keywords:

NICU, Preterm, Drug utilization, Drug prescriptions

Abstract

Background: Repeated and prolonged courses of antibiotics exposure have resulted in an increase in the prevalence of hospital acquired infections and antibiotic resistant profile. The objective of this study was to quantify the use of antibiotics in a neonatal intensive care unit (NICU) from rural tertiary health care centre.

Methods: A hospital based cross-sectional study was conducted in the NICU of tertiary care hospital located in western Maharashtra, India during the year 2011-12. A total of 237 neonates admitted to NICU from October 2011 to March 2012 were enrolled in the study according to inclusion criteria of the study. Demographic details, data on antibiotic prescriptions (name, dose, frequency, route of administration) were recorded by utilizing pre-tested structured proforma.

Results: A total of 3822 prescriptions were received by the neonates and commonly prescribed antibiotics were amikacin (75.53%), cefotaxime (43.34%) and ampicillin (31.33%) respectively. It was also noted that 50% of the drugs prescribed were in compliance with the national list of essential medicines 2011. The max, 68.75% of antibiotics prescribed were in generics forms however, 12.5% were prescribed in the form of fixed dose combinations.

Conclusions: The revealed that 3rd generation cephalosporins and amikacin are most commonly used antibiotics in NICU.

References

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. The Pediatric infectious disease journal. 2009;28(12):1047-51.

Clark RH, Bloom BT, Spitzer AR, Gerstmann DR. Reported medication use in the neonatal intensive care unit: data from a large national data set. Pediatrics. 2006;117(6):1979-87.

Warrier I, Du W, Natarajan G, Salari V, Aranda J. Patterns of drug utilization in a neonatal intensive care unit. The Journal of Clinical Pharmacology. 2006;46(4):449-55.

Straand J, Rokstad K, Heggedal U. Drug prescribing for children in general practice. A report from the møre and romsdal prescription study. Acta paediatrica. 1998;87(2):218-24.

Neubert A, Planner C, Cranswick N. The new European regulation on pediatric medicines. Pediatric Drugs. 2008;10(3):147-9.

Commission E. Regulation (EC) No. 1901/2006 of the European parliament and of the council on medicinal products for paediatric use. European Commission, Brussels, 2006. Available at http://ec.europa.eu/health/files/eudralex/vol-1/reg_2006_1901/reg_2006_1901_en.pdf.

Senate and house of representatives of the United States of America Pediatric Research Equity Act, 2003. Available at http://www.fda.gov/downloads/Drugs/DevelopmentApprovalProcess/DevelopmentResources/UCM077853.pdf.

Bizzarro MJ, Gallagher PG. Antibiotic-resistant organisms in the neonatal intensive care unit. Semin Perinatol. 2007;31(1):26-32.

Cotten CM, Taylor S, Stoll B, Goldberg RN, Hansen NI, Sánchez PJ, et al. Prolonged duration of initial empirical antibiotic treatment is associated with increased rates of necrotizing enterocolitis and death for extremely low birth weight infants. Pediatrics. 2009;123(1):58-66.

Liem TY, Krediet TG, Fleer A, Egberts TC, Rademaker CM. Variation in antibiotic use in neonatal intensive care units in the Netherlands. Journal of Antimicrobial Chemotherapy. 2010;65(6):1270-5.

Dell’Aera M, Gasbarro AR, Padovano M, Laforgia N, Capodiferro D, Solarino B, et al. Unlicensed and off-label use of medicines at a neonatology clinic in Italy. Pharmacy world and science. 2007;29(4):361-7.

Cotten CM, McDonald S, Stoll B, Goldberg RN, Poole K, Benjamin DK. The association of third-generation cephalosporin use and invasive candidiasis in extremely low birth-weight infants. Pediatrics. 2006;118(2):717-22.

Manzoni P, Farina D, Leonessa M, d'Oulx EA, Galletto P, Mostert M, et al. Risk factors for progression to invasive fungal infection in preterm neonates with fungal colonization. Pediatrics. 2006;118(6):2359-64.

Downie L, Armiento R, Subhi R, Kelly J, Clifford V, Duke T. Community-acquired neonatal and infant sepsis in developing countries: efficacy of WHO's currently recommended antibiotics-systematic review and meta-analysis. Archives of disease in childhood. 2013;98(2):146-54.

Muller-Pebody B, Johnson A, Heath P, Gilbert R, Henderson K, Sharland M. Empirical treatment of neonatal sepsis: are the current guidelines adequate? Archives of Disease in Childhood-Fetal and Neonatal Edition. 2011;96(1):F4-F8.

Amikacin. Neonatal formulary 6 - drug use in pregnancy and the first year of life: Wiley Blackwell; 2011:40. Available at https://pharmafed.files.wordpress.com/2013/04/neonatal-formulary-drug-use-in-pregnancy-and-the-first-year-of-life.pdf.

Engler D, Schellack N, Naude A, Gous A. Use of amikacin in neonates and related ototoxicity: neonatology; 2013. Available at http://reference.sabinet.co.za/document/EJC131751.

Vancomycin. Neonatal formulary 6 - drug use in pregnancy and the first year of life: Wiley Blackwell, BMJ Books; 2011:264.

Meropenem. Neonatal formulary 6 - drug use in pregnancy and the first year of life: Wiley Blackwell; 2011:161.

Linezolid. Neonatal formulary 6 - drug use in pregnancy and the first year of life: Wiley Blackwell; 2011:155.

Alcon Laboratories. Tobramycin - summary of product characteristics. Frimley business park, frimley, Camberley, GU16 7SR, UK: EMC; 2012. Available at http://www.medicines.org.uk/emc/medicine/21263.

Drugs com. Gatifloxacin ophthalmic solution. Wolters kluwer health, 2009. Available at http://www.drugs.com/ppa/gatifloxacin.html.

Sanofi. Ofloxacin IV infusion- summary of product characteristics. 1 Onslow Street, Guildford, Surrey, GU1 4YS, UK EMC; 2011. Available at http://www.medicines.org.uk/emc/medicine/8882.

Neonatal formulary 6 - drug use in pregnancy and the first year of life: Wiley Blackwell, BMJ Books; 2011. Available at http://as.wiley.com/WileyCDA/WileyTitle/productCd-1118819594.html.

Downloads

Published

2017-01-05

How to Cite

Shinde, A. R., Bairagi, J. M., Khanwelkar, C. C., Shinde, R. V., & Mohite, R. V. (2017). Pattern of antibiotic use in neonatal intensive care unit in tertiary care hospital in Southern India. International Journal of Basic & Clinical Pharmacology, 5(4), 1563–1568. https://doi.org/10.18203/2319-2003.ijbcp20162473

Issue

Section

Original Research Articles