The tendency in the use of the antibiotics, and is evidence of resistance in culture-positive cases.

Abstract

Objective: To evaluate the trend of antibiotic use in neonatal sepsis and to evaluate the prevalence of antimicrobial re-sistance in culture-positive cases
Methodology: This retrospective observational study was done in the Neonatal Intensive Care Unit (NICU) of a tertiary care hospital, Hashim Medical City, Hyderabad. This research involved nearly 120 + infants who were hospitalized with-in the specified study period. The information was collected in the medical records of the hospital, the admission rec-ords, and the laboratory records.
Results: Cohort showed male preponderance (60 65 percent), and gestational age was 26 to 40 weeks. Most of the neo-nates were preterm (6570%). Weights of birth were between 0.69 and 3.9kg with almost 70 percent of the children hav-ing low birth weight and a few cases of extremely low birth weight. The majority of the deliveries were through LSCS/elective LSCS and a large percentage of neonates were peripheral center referrals. The most frequent were respiratory distress syndrome, transient tachypnea of the newborn, birth asphyxia and neonatal sepsis. Many of them needed repiratory support, such as CPAP and mechanical ventilation; often oxygen therapy was used. Length of stay was 1-58 days. The outcome measures were discharge, mortality, referral, and leave against medical advice (LAMA), with mortali-ty being higher in cases of neonates with severe sepsis and extreme prematurity. The use of broad-spectrum antibiotic therapy was a common practice of empirical antibiotic therapy, such as aminoglycosides, vancomycin, and car-bapenems. A majority were culture-negative, but culture-positive cases showed pathogens to include Staphylococcus aureus, Klebsiella, Serratia, Acinetobacter, and E. coli. Multidrug resistance was evidenced especially in Gram-negative organisms.
Conclusion: Overuse of broad-spectrum antibiotics and emerging resistance indicate enhanced need to improve stew-ardship and infection control measures.
Key words: antibiotics, resistance, swab culture, neonatal intensive care, birth asphyxia.