Mr Christian Magnus Thaulow1, Dr Dag Berild2, Dr Hege Salvesen Blix4, Dr Beate Horsberg Eriksen3
1Haukeland University Hospital, Bergen, Norway,
2University of Oslo, Oslo, Norway,
3Møre and Romsdal Hospital Trust, Ålesund Hospital, Ålesund, Norway,
4Norwegian Institue of Public Health, Oslo, Norway
We have investigated the potential for improved antibiotic stewardship in neonates in two Norwegian hospitals, with emphasis on antibiotic exposure in unconfirmed infections, treatment length/doses, CRP values and the use of broad-spectrum antibiotics (BSA).
We conducted a prospective period incidence survey of antibiotic use in a Norwegian university hospital (UH) and a district hospital (DH), 2017. Ninety-five neonates at the DH and 89 neonates at the UH treated with systemic antibiotics were included in the study.
n total, 685 prescriptions (daily doses) of antibiotics were given at the DH and 903 at the UH. Among term and premature infants (≥ 28 weeks), 82% (75% at the UH and 86% at the DH, p= 0.172) of the treatments for suspected early-onset sepsis were for unconfirmed infections, and average treatment length in these cases was 3.1 days (both hospitals). Median dose for aminoglycoside was higher for term infants at the UH (5.96, 95% CI 5.02-6.89) compared to the DH (4.98, 95% CI 4.82-5.14) (p<0.001). At the UH, all prescriptions with aminoglycosides were gentamicin, while tobramycin accounted for 93% of all prescriptions with aminoglycosides at the DH.
There is a potential for reduction in both antibiotic exposure and treatment length in these two neonatal units, and a systematic risk/observational algorithm of sepsis should be considered in both hospitals. Doses and choice of aminoglycosides varied between the hospitals.
Pediatric ID doctor currently conducting a research project targeting antibiotic use and resistance rates in Norwegian children and neonates with the aim of improving pediatric antibiotic stewardship programs in Norway