Universidad Peruana Cayetano Heredia

Antibiotic overuse in premature low-birth-weight infants in a developing country

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dc.contributor.author Rueda, M.S.
dc.contributor.author Calderon-Anyosa, R.
dc.contributor.author Gonzales, J.
dc.contributor.author Turin, C.G.
dc.contributor.author Zea-Vera, A.
dc.contributor.author Zegarra, J.
dc.contributor.author Bellomo, S.
dc.contributor.author Cam, L.
dc.contributor.author Castaneda, A.
dc.contributor.author Ochoa Woodell, Theresa Jean
dc.date.accessioned 2019-12-06T21:02:57Z
dc.date.available 2019-12-06T21:02:57Z
dc.date.issued 2019
dc.identifier.uri https://hdl.handle.net/20.500.12866/7513
dc.description.abstract Background: Neonatal sepsis is a leading cause of child morbidity and mortality, especially in premature and low birth weight infants. Prompt antibiotic therapy is warranted, but its inappropriate use leads to bacterial resistance and adverse outcomes. Our objective is to describe the antibiotic use for late-onset sepsis in Peruvian premature infants. Methods: This study is a prospective study as a secondary analysis of a clinical trial in 3 neonatal care units in Peru. We included infants in the first 72 hours of life, with birth weight (BW) <2000 g. We described the antibiotic use as length of therapy (LOT) per 1000 patient days (PD) and antibiotic courses. Results: We included 408 neonates, with 12,204 PD of follow-up; 253 infants (62%) had a BW ≤1500 g. Total antibiotic use for late-onset sepsis was 2395 LOT (196 LOT/1000 PD). Two-hundred and seventy-one patients (66.4%) did not receive antibiotics for late-onset sepsis during their hospitalization. In total, 204 antibiotic courses were administered; 92 infants (22.5%) received 1 course, and 45 (11.0%) received 2-5 antibiotic courses. Mean duration of antibiotic course was 10.8 days (standard deviation: ±7.3). We found a significant association between a lower BW and increased antibiotic use per day (P < 0.001). The most commonly used antibiotics were vancomycin (143 LOT/1000 PD), carbapenems (115 LOT/1000 PD), aminoglycosides (72 LOT/1000 PD) and ampicillin (41 LOT/1000 PD). Conclusions: Premature infants receive antibiotics for longer than recommended periods of time. Antibiotic overuse is greater in neonates with lower BW. Vancomycin is the most used antibiotic. There is an urgent need to develop antimicrobial stewardship programs in our setting. en_US
dc.language.iso eng
dc.publisher Wolters Kluwer Health
dc.relation.ispartofseries Pediatric Infectious Disease Journal
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject amikacin en_US
dc.subject aminoglycoside en_US
dc.subject ampicillin en_US
dc.subject antibiotic agent en_US
dc.subject antibiotics en_US
dc.subject antimicrobial stewardship en_US
dc.subject Article en_US
dc.subject birth weight en_US
dc.subject carbapenem derivative en_US
dc.subject cefepime en_US
dc.subject cefotaxime en_US
dc.subject ceftazidime en_US
dc.subject child hospitalization en_US
dc.subject ciprofloxacin en_US
dc.subject controlled study en_US
dc.subject developing country en_US
dc.subject double blind procedure en_US
dc.subject drug indication en_US
dc.subject follow up en_US
dc.subject gentamicin en_US
dc.subject human en_US
dc.subject imipenem en_US
dc.subject infant en_US
dc.subject late onset disorder en_US
dc.subject linezolid en_US
dc.subject low birth weight en_US
dc.subject lumbar puncture en_US
dc.subject major clinical study en_US
dc.subject medication overuse en_US
dc.subject meningitis en_US
dc.subject meropenem en_US
dc.subject metronidazole en_US
dc.subject neonates en_US
dc.subject newborn en_US
dc.subject newborn care en_US
dc.subject piperacillin plus tazobactam en_US
dc.subject prematurity en_US
dc.subject priority journal en_US
dc.subject prospective study en_US
dc.subject randomized controlled trial en_US
dc.subject secondary analysis en_US
dc.subject sepsis en_US
dc.subject treatment duration en_US
dc.subject vancomycin en_US
dc.title Antibiotic overuse in premature low-birth-weight infants in a developing country en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1097/INF.0000000000002055
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.03
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.08
dc.relation.issn 1532-0987


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