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.