Manisha Das1, Nandita Pal2, Sanat Kumar Dolui3, Supriyo Choudhury4
1Department of Pharmacology, College of Medicine and Sagore Dutta Hospital, Kamarhati, West Bengal, India.
2Department of Microbiology, College of Medicine and Sagore Dutta Hospital, Kamarhati, West Bengal, India.
3Department of Paediatrics, Calcutta National Medical College, Kolkata, West Bengal, India.
4Department of Neurology, Institute of Neurosciences Kolkata, Kolkata, West Bengal, India.
Introduction: Antimicrobials are the mainstay treatment in neonatal septicemia (NS). National treatment guidelines for antimicrobial use in infectious diseases issued by the Government of India has paved the way for rationalizing antibiotic use, but it needs tailoring according to the prevalent local microbiota and individual patient’s needs. Aperiodic surveillance of the microbial etiology and antibiotic use patterns in NS may be useful in rational selection of empirical antimicrobial therapy. Aims and Objectives: We observed the utilization pattern of antimicrobials and quantified the same in neonates admitted to neonatal intensive care unit (NICU) with septicemia along with the prospective follow‑up of the clinical response to individual regimen. Materials and Methods: This hospital‑based prospective observational study was conducted from January 2017 to June 2017 on 102 consecutive cases of NS admitted to NICU. Data regarding demographic parameters, antimicrobials used, and outcome were collected through a predesigned case record form. Antimicrobial usage was quantified as days of therapy (DOT) per 1000 patient days. Results: Common antimicrobials used in descending order of DOT were amikacin, colistin, and meropenem. Ampicillin, cefotaxime, and gentamicin were rarely found suitable for use based on the reported antibiograms. Piperacillin‑tazobactam + amikacin regimen was the most commonly used empirical regimen. The case fatality rate was 4% in our study sample. Conclusion: Ampicillin, cefotaxime, and gentamicin had limited effectiveness in the majority of cases. Although there is a need of alignment with national treatment guidelines in NS, yet, the concurrent scope of periodic survey and research must be available for changeover to evidence‑based local individualization of empirical antimicrobial therapy wherever required.
Keywords: Antimicrobial use, days of therapy, neonatal septicemia, neonatal intensive care unit