title: Antibiotic use and misuse in the neonatal intensive care unit.
abstract: Neonatal sepsis causes significant morbidity and mortality, especially in preterm infants. Clinicians are compelled to treat with empiric antibiotics at the first signs of suspected sepsis. Broad-spectrum antibiotics and prolonged treatment with empiric antibiotics are associated with adverse outcomes. Most common neonatal pathogens are susceptible to narrow-spectrum antibiotics. The choice of antibiotic and duration of empiric treatment are strongly associated with center-based risk factors. Clinicians should treat with short courses of narrow-spectrum antibiotics whenever possible, choosing the antibiotics and treatment duration to balance the risks of potentially untreated sepsis against the adverse effects of treatment in infants with sterile cultures.
authors.affiliation: Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: Nidhi
authors.initials: N
authors.lastname: Tripathi
authors.forename: C Michael
authors.initials: CM
authors.lastname: Cotten
authors.forename: P Brian
authors.initials: PB
authors.lastname: Smith
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D024881:Drug Resistance, Bacterial; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000188:drug therapy*; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy; D007363:Intensive Care Units, Neonatal; D008826:Microbial Sensitivity Tests; D012307:Risk Factors; D018805:Sepsis / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents