Abstract
The drug utilization evaluation, particularly for antimicrobials, minimizes the drug-related problems, specifically antimicrobial resistance and adverse events which are prime area of concerns in neonatal intensive care units (NICU). However, the data on antimicrobial consumption among neonates is limited in Saudi Arabia. This pilot analysis aimed to prospectively review the drug, specifically antimicrobials, in NICU. This prospective observational study involved neonates admitted to Maternity and Children Hospital (MCH), Saudi Arabia during June, 2019. The use of drugs was evaluated for each day of hospitalization until discharge, transfer out or death, whichever occurred earlier. A total of 21 neonates (age: 33.8 +/- 4.1 weeks, male: 47.6%) admitted to NICU during the study period. Of these, 66.7% were preterm and had respiratory distress syndrome (71.4%) as major indication. Dopamine was frequently prescribed (47.6%) followed by caffeine citrate (42.9%). All patients received empiric antimicrobials at average 3.1 +/- 1.2 drugs. Ampicillin was frequently prescribed (95.2%) followed by cefotaxime (61.9%), vancomycin (57.1%) and gentamicin (47.6%). All the neonates were subjected for culture sensitivity testing and only two showed positive results for Staphylococcus epidermidis and Klebsiella pneumoniae. The empirical antibiotics were discontinued in 52.4% patients after getting the culture sensitivity results. However, 8 patients with negative culture sensitivity still received antibiotics. The empiric use of antimicrobials reduced to average 0.86 +/- 1.01 drugs per patient. The average length of stay in NICU was 8.5 +/- 6.3 days. This study showed high consumption of empirical antimicrobials such as penicillin and cephalosporin in neonates, event after receiving negative culture tests. Since unnecessary use of antibiotics may cause serious events in this high prone population, aggressive maneuvers to monitor the drug use in such specialized units is highly recommended.