Neonatal Sepsis and Use of Antibiotic in a Tertiary Care Hospital

Background: Neonatal infections currently cause 1.6 million deaths in developing countries. Resistance to commonly used drug is emerging as the most important problem globally. Therefore rational use of antibiotic is a priority to reduce the burden of treatment failure. Objective: To evaluate the magnitude of neonatal infections in the neonatal ward of a medical institution and pattern of antibiotic use in these cases. Methodology: This was a cross sectional retrospective study. All the cases of neonatal infections admitted between October 2003 to September 2005 were included in the study. Relevant informations like age, sex, birth weight, investigations, diagnosis, antibiotic use and outcome were noted in the predesigned proforma. Infection within first week of birth was regarded as the early onset infections and infections thereafter were considered as late onset infections. Results: Eleven hundred and ninety six cases got admitted in the neonatal ward during the 24 months of study period. Three hundred and thirty four neonates with sepsis constituted 27.8% of the total cases. Majority of these cases were early onset infections (70.7%). Septicemia was the commonest (34.6%) major infections followed by pneumonia (19.5%). The dominant minor infections were umbilical sepsis (10.5%) and pyoderma (6.9%). The most frequently used antimicrobial agent was third generation cephalosporin (36.2%) and next in order was the combination of ampicillin and gentamycin (18.9%). Regarding outcome 78.1% cases recovered well. Among the rest of the cases with unsatisfactory progress, 12.3% died in the hospital. Conclusion: Neonatal sepsis constituted nearly one third of the health problem in neonatal ward and majority of them are early onset infections. Septicemia is the most frequently encountered infections and costly third generation cephalosporin topped the list of antibiotic use.