Evaluating antibiotic use in a secondary level hospital neonatal unit in the Western Cape, South Africa

Abstract

Perinatal infection signifcantly contributes to neonatal morbidity and mortality. There are no reliable rapid diagnostic tests. Drug resistance is increasing in organisms acquired in hospital. There are little data on the indications for antibiotic use and the prevalent organisms in lower resource settings, and none in regional hospitals in South Africa. We conducted a retrospective cohort study of risk factors, indications for and drugs used at Worcester Provincial Hospital Neonatal Unit. A systematic sample of every alternate neonate listed in the admissions register from 1 July 2005 to 30 June 2006 was taken. Charts for all cases were reviewed. Early antibiotic use was defned as therapy within 72 hours of life. One hundred and ninety-fve infants where included; 144 (74%) had 194 antibiotic events. Antibiotic events occurred at a rate of 99 events per 100 neonates. Prematurity was common (83% of admissions) and, in conjunction with prolonged rupture of membranes, was the major driver of early antibiotic...