Author/Authors :
Fahimzad, Alireza Pediatric Infections Research Center - Research Institute For Children Health - Shahid Beheshti University of Medical Sciences, Tehran , Eydian, Zahra Department of Pediatrics - Zabol University of Medical Sciences, Zabol , Karimi, Abdollah Pediatric Infections Research Center - Research Institute For Children Health - Shahid Beheshti University of Medical Sciences, Tehran , Shiva, Farideh Pediatric Infections Research Center - Research Institute For Children Health - Shahid Beheshti University of Medical Sciences, Tehran , Armin, Shahnaz Pediatric Infections Research Center - Research Institute For Children Health - Shahid Beheshti University of Medical Sciences, Tehran , Mansour Ghanaei, Roxana Pediatric Infections Research Center - Research Institute For Children Health - Shahid Beheshti University of Medical Sciences, Tehran , Fallah, Fatemeh Pediatric Infections Research Center - Research Institute For Children Health - Shahid Beheshti University of Medical Sciences, Tehran , Rafiei Tabatabaei, Sedigheh Pediatric Infections Research Center - Research Institute For Children Health - Shahid Beheshti University of Medical Sciences, Tehran , Shirvani, Fariba Pediatric Infections Research Center - Research Institute For Children Health - Shahid Beheshti University of Medical Sciences, Tehran , Rahbar, Mohammad Antimicrobial Resistance Research Center - Iran University of Medical Sciences, Tehran , Sayyahfar, Shirin Department of Microbiology - Iranian Reference Health Laboratory - Ministry of Health and Medical Education, Tehran , Kahbazi, Manijeh Antimicrobial Resistance Research Center - Iran University of Medical Sciences, Tehran , Rahbarimanesh, Aliakbar Department of Pediatrics - Aliasghar Children Hospital - Iran University of Medical Sciences, Tehran , Arjmand, Reza Tuberculosis and Pediatrics Infectious Disease Research Center - Arak University of Medical Sciences, Arak , Sanaei Dashti, Anahita Department of Pediatric Infectious Diseases - Bahrami Children Hospital - Tehran University of Medical Sciences, Tehran , Abdinia, Babak Department of Pediatrics - Alborz University of Medical Sciences, Karaj , Abedini, Masomeh Professor Alborzi Clinical Microbiology Research Center - Shiraz University of Medical Sciences , Hidari, Hossein Department of Pediatrics - Faculty of Medicine - Tabriz University of Medical Sciences, Tabriz , Ghadiri, Keyghobad Department of Pediatrics Faculty of Medicine - Sanandaj University of Medical Sciences, Sanandaj , Sharif, Aminsadat Pediatric Medicine Research Center - Qom University of Medical Sciences, Qom , Shafighi Shahri, Elham Nosocomial Infection Research Center - Kermanshah University of Medical Sciences, Kermanshah , Shariat, Zeynab Pediatric Department - Faculty of Medicine - Hamadan University of Medical Sciences, Hamadan , Nejadian, Ali Children and Adolescent Health Research Center - Zahedan University of Medical Sciences, Zahedan , Moshayedi, Mona Department of Pediatrics Infectious Disease and Tropical Medicine Research Center - Isfahan University of Medical Sciences, Isfahan , Fatholahpoor, Samaneh Department of Pediatric Infectious Disease - Abuzar Children Medical Center Hospital - Ahvaz Jundishapour University of Medical Sciences , Alizadeh, Hamid Antimicrobial Resistant Nosocomial Infection Research Center - Mazandaran University of Medical Sciences, Sari , Entezari Heravi, Reza Non-Communicable Pediatric Diseases Research Center - Babol University of Medical Sciences, Babol
Abstract :
Background: The association between the use of antibiotics and bacterial resistance has obviously been established and it seems to be a significant problem for public
health. It is clear that irrational use and high rates of antibiotic prescription are associated with increased bacterial resistance. As antibiotics are the class of drugs
commonly prescribed in neonatal and Neonatal Intensive Care Unit (NICU) wards, neonates are at high risk of opportunistic or nosocomial infections due to prolonged
hospitalization and immunosuppressed condition.
Objectives: It is essential for antibiotic prescription patterns to be evaluated periodically for rational use. Therefore, the present study was carried out to identify the
prescribing patterns of antibiotics in neonatal and NICU wards of 17 different Iranian hospitals.
Methods: The study was done during 1 calendar week between January and February 2014. All in-patients admitted to the NICU and neonatal units of 17 Hospitals in 15
Iranian cities were included. Relevant data of all neonates receiving an antibiotic at 8amon the day of the study was collected by trained members of the study team; age
of the patients, type and number of administered antibiotics, route of administration, underlying disease, and indication for use were documented.
Results: The total number of neonatal in-patients was 366 on the day of the study. Mean age of infants was 9.23.9 days, with 54.4% being male. Overall, 264 patients
(72.1%) were being given one or more antimicrobials; the proportion of patients receiving antibiotics ranged from 21.4% to 100% in different neonatal units. Most frequent
antibiotics used were ampicillin (25.6%), vancomycin (16.4%), amikacin (10.6%), and cefotaxime (9.74%). Parenteral route was used in 255 cases, (96.6%); 110 (41.7%) antibiotic
courses were prescribed for community-acquired infections, 29 (11 %) for hospital-acquired infections, 42 (15.9 %) for pre- or post-operative prophylaxis, and 83 (31.4 %) for
medical prophylaxis. Empirical antibiotics were administered to 255 newborns (96.6 %); 96.2% of patients received combination therapy.
Conclusions: High use of empirical and prophylactic antibiotics, overuse of vancomycin and third generation cephalosporins are of concern and contrary to recommended
therapies. Therefore, guidelines for the use of antibiotics in neonates are required and a larger number of studies are needed.
