Antibiotic Use in Neonates of Birth-weight < 2000 G Surviving to Discharge.

BACKGROUND: Symptoms and signs of infection are non-specific in neonates. Hence, neonates, especially low birth-weight and premature ones, often receive empirical antibiotics. This study was conducted to assess the use of antibiotics in newborns with a birth-weight of < 2000 g at a tertiary care service hospital.
METHODS: All infants < 2000 g at birth admitted to NICU were include Data on symptoms, investigations for infection and use of antibiotics were collected in addition to baseline data. The data of those surviving to discharge was analyzed.
RESULTS: Out of 52 eligible infants, 3 died; thus data from 49 neonates was analyzed. Preterm infants formed 89.8% of this group while 36.73% were Small for Gestational Age (SGA). Symptoms were present in 22 (44.9%) of whom 13(59.1%) received antibiotics. Lower birth weight, lower gestational age and male sex predisposed to increased antibiotic use. A total of 21 courses of antibiotics were administered which averaged to 1.6 course or 15 days of therapy per patient. The most common combination used was cefotaxime-amikacin in 42.9% followed by ampicillin-gentamicin in 33.3%. The overall mortality for this group was 5.8% while mortality due to infection was 1.9%.
CONCLUSION: Attention to asepsis in the NICU, close monitoring and judicious use of antibiotics only when indicated can result in decreased empirical use of antibiotics and better outcome. Low birth-weight, prematurity and male sex are significantly associated with antibiotic use in this study.