Antibiotic Prescribing Patterns in a Neonatal Intensive Care Unit

ABSTRACT

An outbreak of invasive candidiasis in the neonatal intensive care unit (NICU) of the Dr George Mukhari Academic Hospital in Ga-Rankuwa necessitated evaluation of the antibiotic prescribing practices in the unit. A selective randomised sample of 100 patients was followed up over a nine-month period to evaluate prescribing patterns. The existing antibiotic policy was used to compare the prescription practices and use of antibiotics. The frequency of use; number of antibiotics per patient and duration of use were documented. Of the 100 patients followed; 95 were prescribed intravenous antibiotics. All prescribed antibiotics for 77 patients are listed in the antibiotic policy. Nineteen different antibiotics were prescribed; and 11 of the 19 prescribed antibiotics appear in the antibiotic policy. Most patients received more than two antibiotics during their stay; as the average number of antibiotics used per patient during the study period was 3.4. The average duration of use for all antibiotics; except cefepime and ceftriaxone; was for longer than seven days. Although antibiotics were used according to the ward protocol in the majority of patients; deviations from the protocol were associated with patients' clinical condition and/or results from blood cultures. The duration of antibiotic use needs to be monitored to prevent unnecessary prolonged use; as in this investigation. An antibiotic policy may be useful to guide and measure rational antibiotic therapy in a NICU