Impact of Antibiotic Policy on Antibiotic Consumption in a Neonatal Intensive Care Unit in India.

OBJECTIVE To study the impact of initiating antibiotic policy on antibiotic consumption in a neonatal intensive care unit (NICU). METHODS This retrospective study was conducted between January, 2013 and December, 2014 in a 30 bed NICU. The antibiotic policy for neonatal sepsis was initiated on January 1st, 2014. The overall antibiotic consumption (Daily Defined Dose [DDD] per 100 patient-days), one year before and one year after the initiation of antibiotic policy was evaluated using interrupted time-series analysis. RESULTS There was no significant change (12.47 vs. 11.47 DDD/100 patient-days; P = 0.57) in overall antibiotic consumption. A significant increase in the proportion of patients on first-line agents (ampicillin and gentamicin) (66% (n=449) vs. 84% (n=491); P <0.001) and significant decrease in consumption of third generation cephalosporins (1.45 vs. 0.45 DDD/100 patient-days; P =0.002) was observed. Conclusion Antibiotic policy increased the use of first-line agents and decreased the consumption of third generation cephalosporins.