TITLE:
Antibiotic Use in a Cohort of Extremely Low Birth Weight Neonates: Focus on Off-Label Uses and Prescription Behaviour
AUTHORS:
Laura Cuzzolin, Rocco Agostino
KEYWORDS:
Antibiotics, ELBW Neonates, Off-Label Use, Variability
JOURNAL NAME:
Pharmacology & Pharmacy,
Vol.9 No.9,
September
27,
2018
ABSTRACT: Aim: To analyse antibiotic prescriptions in a cohort of
extremely low birth weight neonates admitted to Italian level III Neonatal intensive
Care Units. Methods: An online
questionnaire was used to collect detailed information for each newborn.
Antibiotic prescriptions were classified about their license status and compared
with British National Formulary for Children (BNFC) and with a practical guide
prepared by the Italian Society of Neonatology (ISN). Results: During the study period (May-July 2014)
among 93 neonates admitted to 30 Italian Neonatal intensive Care Units, 56 (60%)
received at least an antibiotic (92 prescriptions in total). Ampicillin,
gentamicin and vancomycin were the antibiotics most commonly used for the
prevention/treatment of bacterial infections.
56/92 antibiotic prescriptions (61%) resulted off-label mainly as regards dosing frequency, while 13
prescriptions (14%) regarded antibiotics used in absence of specific indication
for newborns (meropenem, imipenem, piperacillin/tazobactam, clindamycin,
clarithromycin). 50/56 neonates (89.3%) received at least one off-label antibiotic prescription.
Differences have been observed in dosing regimens between current study and
recommendations contained in BNFC, while prescriptions adhered more
frequently to ISN indications. Conclusions: Our results confirm the high
prevalence of off-label antibiotic use
in ELBW neonates and underline a better adherence to indications based on
clinical practice.