1650 Rational use of Antibiotics in Newborn

Abstract

Side efects of antibiotics must always be considered, especialy in neonatal period. Our aim was to analise the antibiotic use in our neonatal ward(2nd level perinatal care).We analised number of babies who received therapy, indications and time of starting antibiotics, duration and antibiotis used, laboratory analysis (CBC, CRP, swabs and cultures of babies and mothers))and discharge diagnosis in one-year period. 2299 babies were born in 2011, and 125(5.4%) recived antibiotics. 49% had risk factors for infection. In 62% therapy started in 1st or 2nd day of life, and average duration was 5-7 days, in 83%. Ampicillin+Gentamycin was given in 82%; Ampicillin for GBS colonisation and cefalosporines for UTI. There were no multiresistant strains. Diagnosis Respiratory: 43 (34.4%), Asphyxia: 17 (13.6%), Urinary tract infections: 15 (12%), Sepsis: 6 (4.8%), Others: 13 (10.4%), Without diagnosis: 31 (24.8%). Risk factors for infection were present in 20% (ITU group) to 58% (group without diagnosis). Positive laboratory analysis were present from 42% (respiratory problems) to 100% in sepsis and UTI. Most of the children received therapy for clinical symptoms of infection, mostly RD. The only single risk factor for starting the therapy was chorioamnionitis. Among children without diagnosis, 4 received short-course therapy based on risk factors, 6 because of GBS colonization, some had risk factors accompanied with positive laboratory findings and 10 babies because of positive laboratory findings only. We noticed the decresement in antibiotis use in our hospital in past few years, specialy in profilactic use and thepary based on laboratory analysis. We consider clinical findings the most important criteria. But we can make further reduction by establishing firm criterias for antibiotic use, improving laboratory technics and probably shortening the duration of therapy in some children.