Antibiotic use in neonatal care: measuring cumulative exposure in point prevalence surveys identifies high infant-level antibiotic exposure

What was done

We looked at antibiotics that neonates received up until the final survey as part of the NeoIPC colonization feasibility assessment in 18 hospitals in 7 European countries. This is important to consider as neonates can receive antibiotics throughout a long stay in the NICU – we need to know how to measure antibiotic exposure to be able to design and evaluate antibiotic stewardship interventions.

Main take-home result

• There is high use of antibiotics in neonatal units in Europe. While WHO Access group antibiotics are most commonly used, there was still high use of Watch and Reserve group antibiotics in vulnerable pre-term neonates later in their inpatient stay.
• The current way we measure antibiotic use doesn’t capture repeated antibiotic exposure in long-stay infants.

What are the implications for children’s health? Will there be a follow up?

• Babies who stay in hospital for a long time can be repeatedly exposed to antibiotics and are more to WHO Watch and Reserve group antibiotics.
• Different methods for capturing this repeated long-term antibiotic exposure are needed. 
• We will then be looking at the relationship of antibiotic exposure on colonization with bacteria over time through this and the data collected as part of the NeoDeco trial. 
• Other studies may be needed to look at other relationships with antibiotic exposure and outcomes – this is beyond the scope of NeoIPC.
• Other studies may be needed to improve antibiotic use (reduce exposure where it may not be necessary) – but this is beyond the scope of NeoIPC.