Neonatal Antibiotic Use: How Much Is Too Much?

Antimicrobial stewardship efforts benefit the individual and the community by improving patient-specific outcomes as well as decreasing the overall burden of antimicrobial resistance. Antibiotic stewardship can also save the health care system substantial amounts of money through decreased pharmacy costs, decreased inpatient use for antibiotic-resistant infections, and decreased frequency of antibiotic-associated adverse events.¹ In NICUs, infants are frequently exposed to antimicrobial medications as prophylaxis against infection, as empirical treatment of suspected infection, and as targeted treatment of confirmed infection. Most neonatal antibiotic treatment is for suspected rather than proven infection, and researchers in several studies suggest that antibiotics are overused in both term and preterm infants.^2,–8 Evolving concern for unintended harm from neonatal antibiotic exposures has energized interest in the general principles of antimicrobial stewardship.^3,5,9,–13 Stewardship recommendations and quality collaborative programs support the appropriate use of antimicrobial...