title: Antimicrobial therapy in neonatal intensive care unit.
abstract: Severe infections represent the main cause of neonatal mortality accounting for more than one million neonatal deaths worldwide every year. Antibiotics are the most commonly prescribed medications in neonatal intensive care units (NICUs) and in industrialized countries about 1% of neonates are exposed to antibiotic therapy. Sepsis has often nonspecific signs and symptoms and empiric antimicrobial therapy is promptly initiated in high risk of sepsis or symptomatic infants. However continued use of empiric broad-spectrum antibiotic treatment in the setting of negative cultures especially in preterm infants may not be harmless.The benefits of antibiotic therapy when indicated are clearly enormous, but the continued use of antibiotics without any microbiological justification is dangerous and only leads to adverse events. The purpose of this review is to highlight the inappropriate use of antibiotics in the NICUs, to exam the impact of antibiotic treatment in preterm infants with negative cultures and to summarize existing knowledge regarding the appropriate choice of antimicrobial agents and optimal duration of therapy in neonates with suspected or culture-proven sepsis in order to prevent serious consequences.
authors.affiliation: Neonatologia, Patologia Neonatale e Terapia Intensiva neonatale, Fondazione IRCCS Policlinico San Matteo, Piazzale Golgi 19, 27100, Pavia, Italy. c.tzialla@smatteo.pv.it.
authors.forename: Chryssoula
authors.initials: C
authors.lastname: Tzialla
authors.affiliation: Neonatologia, Patologia Neonatale e Terapia Intensiva neonatale, Fondazione IRCCS Policlinico San Matteo, Piazzale Golgi 19, 27100, Pavia, Italy. alessandroborghesi@yahoo.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Borghesi
authors.affiliation: Terapia Intensiva Neonatale Dipartimento di Scienze per la Promozione della Salute e Materno Infantile "G. D'Alessandro", Università degli Studi di Palermo, Via Alfonso Giordano, 390127, Palermo, Italy. gregorio.serra@alice.it.
authors.forename: Gregorio
authors.initials: G
authors.lastname: Serra
authors.affiliation: Neonatologia, Patologia Neonatale e Terapia Intensiva neonatale, Fondazione IRCCS Policlinico San Matteo, Piazzale Golgi 19, 27100, Pavia, Italy. m.stronati@smatteo.pv.it.
authors.forename: Mauro
authors.initials: M
authors.lastname: Stronati
authors.affiliation: Terapia Intensiva Neonatale Dipartimento di Scienze per la Promozione della Salute e Materno Infantile "G. D'Alessandro", Università degli Studi di Palermo, Via Alfonso Giordano, 390127, Palermo, Italy. giovanni.corsello@unipa.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Corsello
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data*; D014943:Global Health; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000188:drug therapy* / Q000453:epidemiology; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*
chemical_list: D000900:Anti-Bacterial Agents