Antibiotics Overused in Neoatal Intensive Care Units: Study

The findings of a new study suggest that pediatric neonatal intensive care units (NICU) may be giving newborns too many antibiotics, which may pose long-term risks with the emergency of antibiotic-resistant bacteria. 

Researchers found pediatric neonatal intensive care unit (NICU) antibiotic use varied as much as 40-fold between different hospitals, with some giving virtually all infants antibiotics during their entire stay in the unit. The findings were published April 20, in the medical journal Pediatrics.

The retrospective cohort study by researchers from Stanford University and California Children’s Services analyzed the data from more than 52,000 infant hospitalizations in 127 NICUs within California during 2013. They compared antibiotic usage with rates of proven infection, necrotizing enterocolitis (NEC), mortality and other factors.

According to the findings, antibiotic use varied from 2.4% to 97% of patient days. The average rate of use was 24.5%.

At all levels of use, researchers found that doctors gave newborns antibiotics even when they had no proven infection, necrotizing enterocolitis (NEC), or surgical need.

Nearly half of NICU’s used antibiotics more than 25% of the time, while half used it less than 25% of the time. In most of these cases, the reported infection rates of the infants was zero.

Overall, surgical cases, infant deaths or NEC had no bearing on whether antibiotics were used on infants, leading researchers to conclude antibiotics are being used when they are not needed.

Concerns Over Unnecessary Antibiotic Use

Researchers remained concerned about the increasing use of antibiotics as recent studies have shown antibiotic overuse may contribute to the creation of antibiotic-resistant bacteria.

A CDC study published in 2013 revealed antibiotic-resistant superbugs are on the rise in U.S. hospitals, placing many patients at risk of death. CDC officials say up to half of superbug infections become fatal.

A British report published late last year warns by the year 2050 nearly 10 million deaths will be attributable to antibiotic resistant infections every year, unless drastic measures are taken to stop the increasing risks.

Infant treatment with antibiotics is a mainstay in NICUs, yet prescribing practices vary depending on the doctor’s ability to determine the likelihood that an infant has a life threatening infection. Doctor’s must quickly assess the risk against the benefit, and they may often be wrong.

In most instances when an infant has a major infection it can be catastrophic, resulting in serious side effects including death, if the infection is not treated quickly. Thus, doctors often err on the side of caution and prescribe antibiotics.

However, cautionary prescribing treatment also has risks. Prescribing antibiotics can increase the risk of infection, death and NEC in infants. Antibiotics have also been linked to a higher risk of asthma later in life.

A study published in 2014 concluded using multiple aggressive doses of antibiotics to treat drug-resistant pathogens may not be helping in warding off the pathogens, but may be actually contributing to the spread of the superbugs.

A study published in 2013 revealed antibiotics contribute in causing outbreaks of antibiotic-resistant bacterial infections in NICUs. The Greek study revealed nearly half of infants infected in the NICU study carried one particular strain of drug-resistant bacteria.