title: Antibiotic Prescribing Pattern in a Tertiary Level Neonatal Intensive Care Unit.
abstract: BACKGROUND
  Neonatal sepsis is a major cause of morbidity and mortality worldwide especially in developing countries, which justifies early diagnosis and prompt treatment with antibiotics. Antibiotics are the most frequently used medicines in Neonatal Intensive care units. Data regarding rational antibiotic use in neonates is very limited. Hence, it is essential that the antibiotic prescribing patterns be evaluated periodically for its rational use. Therefore, the present study been carried out to identify the prescribing patterns of antibiotics in neonatal intensive care unit of a tertiary care hospital, Western Maharashtra, India.
  
  
  METHODS
  A prospective observational study was carried out for 6 months between April to September 2014. The data regarding patient demographics and antibiotic use was collected daily in a structured proforma. Collected data was subjected to statistical analysis.
  
  
  RESULTS
  Out of total 528 neonates with male preponderance (62%), 370 received antibiotics. Mean gestational age and birth weight were 35±3.2 weeks and 2±0.7 kg respectively. Mean length of hospital stay was 14.26±15.36 days (range 1 to 136 days). A total of 1123 antibiotics were prescribed to 370 neonates. The majority of neonates (55.9%) received between 1-2 antibiotics, 37.3% had 3 to 5 antibiotics prescribed, while 6.7% neonates were prescribed more than 5 antibiotics. Number of antibiotics used had statistically significant inverse relationship with gestational age. Among antibiotics; Amikacin, Cefotaxime and Levofloxacin were the drugs most often prescribed. Amikacin and Cefotaxime were given more to term infants whereas other antibiotics like Levofloxacin, Pipercillin- tazobactam and Meropenem were prescribed more to preterm and outborn neonates.
  
  
  CONCLUSIONS
  The use of a high number of antibiotics is a common practice. Although the indications for use of most antibiotics could be justified, the increased frequency of anbiotics use in some neonates was of concern. Guidelines for the use of antibiotics in neonates are required and larger studies are needed on this issue.
authors.affiliation: Assistant Professor, Department of Pharmacology, Bharati Vidyapeeth Deemed University , Medical College Pune, India .
authors.forename: Sonali
authors.initials: S
authors.lastname: Suryawanshi
authors.affiliation: Professor and Head of Department, Department of Pharmacology, Bharati Vidyapeeth Deemed University, Medical College Pune, India .
authors.forename: Vijaya
authors.initials: V
authors.lastname: Pandit
authors.affiliation: Professor and Head of Department, Department of Neonatology, Bharati Vidyapeeth Deemed University, Medical College Pune, India .
authors.forename: Pradeep
authors.initials: P
authors.lastname: Suryawanshi
authors.affiliation: Post Graduate Student, Department of Pharmacology, Bharati Vidyapeeth Deemed University, Medical College Pune, India .
authors.forename: Aditi
authors.initials: A
authors.lastname: Panditrao
keywords: Antibiotic usage; Neonatal sepsis; Resistance