The Question: In this study, we assessed and compared antibiotic consumption rates among neonatal patients one year before and one year after the initiation of antibiotic policy in a neonatal intensive care unit (NICU) in India to understand the impact of policy on the clinical use of antibiotics. Research findings were published in the journal Indian Pediatrics.

What We Found: In the year following the implementation of antibiotic policy, the proportion of babies on antibiotics decreased significantly to 46 percent from 58 percent in the year before policy implementation. Overall antibiotic consumption decreased from 12.47 to 11.47 daily defines doses (DDD) per 100 patient-days after policy implementation; however, this decline was not statistically significant. With antibiotic policy, the proportion of babies on first line antibiotics (ampicillin and gentamicin) increased and the consumption of third generation cephalosporins decreased significantly without affecting overall or sepsis-related mortality.

Why It Matters: Misuse of antibiotics is one of the primary drivers of antibiotic resistance. Several studies have reported high and inappropriate use of antibiotics in NICUs in India and recommended implementation of antibiotic stewardship policies in these units; however, there were previously no published studies evaluating the impact of antibiotic policy on antibiotic consumption in the NICU setting in India in the era of high antimicrobial resistance. This study provides insight into the impact and utility of antibiotic policy on promoting appropriate antibiotic use in the NICU setting.

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