Investigation Of Antiobotics Rationality In Neonatal Intensive Care Units Before And After The Application Of Control The Antimicrobial

Objecctive:To discuss the influence on the rationality of antibiotics in NICU neonates after the control antimicrobial application.Methods: We conducted a retrospective study about 91 cases discharged in June 2010(Group before control) and 101 cases discharged in June 2015(Group after control) in our NICU. The general data, clinical data and prescription and discontinuance indications of antibiotics were collected. The inappropriate utilization of antibiotics was evaluated via modified CDC 12-step.Results:(1)The median antibiotics courses of group before control was 14d((range,7-23d), The median antibiotics courses of group after control was 16.5 d(range,6-24d), not reaching significantly difference(Z=0.251,P>0.05);(2)69 antibiotics courses(67%) and 406 antibiotic-days(22%) of Group before control were considered unreasonable, however, respectively 56 courses(49%), 357 antibiotic-days(18%) in Group after control. Significant difference was found between two groups(x~2=5.711 vs. x~2=15.018, respectively,P<0.05); 3) Inappropriate use was more common with continuation of antibiotics than with initiation of therapy(Group before control 25% vs. 47%,Group after control 25% vs. 56%,respectively,P<0.05);(4)The condition being defined as “Stop treatment if infection cured or unlikely”made up 48% and 57% separately in Group before control and Group after control(x~2=6.274,P<0.05). “Say no to broad-spectrum antibiotics ” situation constituted of 27% and 19% respectively in Group before control and Group after control(x~2=6.005,P<0.05);( 5) Cefoxitin was the most commonly used drug(n=729 antibiotic-days),of which 138 days(19%) were considered inappropriate in Group before control. Penicillin was the most commonly used drug(n=645 antibiotic-days),of which 109 days(17%) were considered inappropriate in Group after control.Conclusions:Rational use of antibiotics improved after the control antimicrobial application. However, the irrationality of antibiotics remained serious in the antibiotics use 72 hours after initiation. Physicians performed unwell in the condition of “Stop treatment if infection cured or unlikely”. When using antibiotics,attention should be payed to clinical symptoms and signs,results of infection biomarker, and stop drugs timely. Meanwhile, neonatologists should avoid third-generation cephalosporin abuse.