Center for Disease Dynamics, Economics & Policy, New Delhi, India.
Rural Development Trust Hospital, Bathalapalli, Andhra Pradesh, India.
Int J Infect Dis. 2018 Jun;71:20-24. doi: 10.1016/j.ijid.2018.03.017. Epub 2018 Mar 30.
Information about antimicrobial use is scarce and poorly understood among neonatal intensive care units (NICUs) in India. In this study, we describe antimicrobial use in eight NICUs using four point prevalence surveys (PPSs).
As part of the Global Antimicrobial Resistance, Prescribing, and Efficacy in Neonates and Children (GARPEC) study, one-day, cross-sectional, hospital-based PPSs were conducted four times between 1 February 2016 and 28 February 2017 in eight NICUs. Using a standardized web-based electronic data entry form, detailed data were collected for babies on antimicrobials.
A total of 403 babies were admitted to NICUs across all survey days, and 208 (51.6%) were prescribed one or more antimicrobials. Among 208 babies, 155 (74.5%) were prescribed antimicrobials for treatment of an active infection. Among 155 babies with an active infection, treatment was empiric in 109 (70.3%). Sepsis (108, 49.1%) was the most common reason for prescribing antimicrobials. Amikacin (17%) followed by meropenem (12%) were the two most commonly prescribed antimicrobials. For community-acquired sepsis, piperacillin-tazobactam (17.5%) was the most commonly prescribed drug. A combination of ampicillin and gentamicin was prescribed in only two babies (5%).
The recommended first-line antimicrobial agents, ampicillin and gentamicin, were rarely prescribed in Indian NICUs for community acquired neonatal sepsis.
印度新生儿重症监护病房（NICU）对抗菌药物使用的信息了解甚少。在这项研究中，我们通过四次四点患病率调查（PPS）描述了 8 家 NICU 的抗菌药物使用情况。
作为全球抗菌药物耐药性、处方和新生儿及儿童疗效（GARPEC）研究的一部分，在 2016 年 2 月 1 日至 2017 年 2 月 28 日期间，8 家 NICU 进行了为期一天的、基于医院的、横断面的 PPS。使用标准化的基于网络的电子数据输入表格，详细收集了婴儿使用抗菌药物的信息。
在所有调查日，共有 403 名婴儿入住 NICU，其中 208 名（51.6%）接受了一种或多种抗菌药物治疗。在 208 名接受抗菌药物治疗的婴儿中，有 155 名（74.5%）是为治疗活动性感染而接受治疗的。在 155 名患有活动性感染的婴儿中，有 109 名（70.3%）接受了经验性治疗。败血症（108 例，49.1%）是最常见的抗菌药物使用原因。氨基糖苷类（17%），其次是美罗培南（12%），是最常使用的两种抗菌药物。对于社区获得性败血症，哌拉西林他唑巴坦（17.5%）是最常使用的药物。只有两名婴儿（5%）使用了氨苄西林和庆大霉素的组合。
在印度的 NICU 中，对于社区获得性新生儿败血症，很少使用推荐的一线抗菌药物，氨苄西林和庆大霉素。
