Babies & newborns Inside the NICU Sunnybrook Magazine – Spring 2017

Decreasing antibiotic use for preemies in the NICU

baby in the NICU

The team behind a new program in the Neonatal Intensive Care Unit (NICU) is reporting a big drop in antibiotic use for premature babies.

The program is called the neonatal antimicrobial stewardship program and its aim is to ensure that antibiotics are used the right way at the right time.

The program started in April 2016 at an information session for staff and parents of the hospital’s frailest patients.

“The problem of antibiotic resistance is a global one, and we can do our part in health care to address it,” says Julie Choudhury, the clinical pharmacist who leads the program.

It has been standard practice for antibiotics to be used in preemies if they’re at all at risk of getting an infection (for instance, if they’re showing respiratory distress) because they can easily acquire one before, during or after birth. An infection in underdeveloped babies can easily become life-threatening.

Part of the reason for this approach is because such young babies “can’t tell us when they’re sick,” and their symptoms can be “non-specific,” Choudhury says.

The team behind the program includes physicians, nursing and pharmacy staff, as well as the parent of a past patient. During their daily rounds, team members share information on the antibiotic each baby is receiving and the overall plan for its use.

Oftentimes, says Choudhury, the antibiotics are discontinued after the team conducts a thorough discussion – focusing on what has been reported about the antibiotic each baby is receiving, the intended plan for the medication, and other possible ways to determine if the baby is under threat of infection.

An analysis completed in November found the use of antimicrobial medications in the NICU had declined by 19 per cent. In the long term, the team is aiming for a 55-per-cent reduction in antibiotic use.

Photography by Doug Nicholson

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Marlene Habib