Practice Summary of Antimicrobial Therapy for Commonly Encountered Conditions in the Neonatal Intensive Care Unit: A Canadian Perspective

Joseph Y Ting; Julie Autmizguine; Michael S Dunn; Julie Choudhury; Julie Blackburn; Shikha Gupta-Bhatnagar; Katrin Assen; Julie Emberley; Sarah Khan; Jessica Leung; Grace J Lin; Destiny Lu-Cleary; Frances Morin; Lindsay L Richter; Isabelle Viel-Thériault; Ashley Roberts; Kyong-Soon Lee; Erik D Skarsgard; Joan Robinson; Prakesh S Shah

doi:10.3389/fped.2022.894005

Practice Summary of Antimicrobial Therapy for Commonly Encountered Conditions in the Neonatal Intensive Care Unit: A Canadian Perspective

Front Pediatr. 2022 Jul 8:10:894005. doi: 10.3389/fped.2022.894005. eCollection 2022.

Authors

Joseph Y Ting^{1

2}, Julie Autmizguine^{3

4}, Michael S Dunn⁵, Julie Choudhury⁶, Julie Blackburn⁷, Shikha Gupta-Bhatnagar⁸, Katrin Assen², Julie Emberley⁹, Sarah Khan¹⁰, Jessica Leung¹¹, Grace J Lin¹², Destiny Lu-Cleary¹³, Frances Morin², Lindsay L Richter², Isabelle Viel-Thériault¹⁴, Ashley Roberts², Kyong-Soon Lee⁵, Erik D Skarsgard¹⁵, Joan Robinson¹⁶, Prakesh S Shah⁵

Affiliations

¹ Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
² Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
³ Division of Infectious Diseases, Department of Pediatrics, Université de Montreal, Montreal, QC, Canada.
⁴ Department of Pharmacology and Physiology, Université de Montréal, Montreal, QC, Canada.
⁵ Division of Neonatology, Department of Pediatrics, University of Toronto, Toronto, ON, Canada.
⁶ Department of Pharmacy, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
⁷ Department of Microbiology, Infectious Diseases and Immunology, Université de Montreal, Montreal, QC, Canada.
⁸ Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
⁹ Division of Neonatology, Department of Pediatrics, University of Manitoba, Winnipeg, MB, Canada.
¹⁰ Department of Microbiology, McMaster University, Hamilton, ON, Canada.
¹¹ Department of Pediatrics, University of Massachusetts, Worcester, MA, United States.
¹² School of Medicine, Queen's University, Kingston, ON, Canada.
¹³ Northern Ontario School of Medicine, Thunder Bay, ON, Canada.
¹⁴ Division of Infectious Diseases, Department of Pediatrics, CHU de Québec-Université Laval, Québec, QC, Canada.
¹⁵ Division of Pediatric Surgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada.
¹⁶ Division of Infectious Diseases, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.

Abstract

Neonates are highly susceptible to infections owing to their immature cellular and humoral immune functions, as well the need for invasive devices. There is a wide practice variation in the choice and duration of antimicrobial treatment, even for relatively common conditions in the NICU, attributed to the lack of evidence-based guidelines. Early decisive treatment with broad-spectrum antimicrobials is the preferred clinical choice for treating sick infants with possible bacterial infection. Prolonged antimicrobial exposure among infants without clear indications has been associated with adverse neonatal outcomes and increased drug resistance. Herein, we review and summarize the best practices from the existing literature regarding antimicrobial use in commonly encountered conditions in neonates.

Keywords: antimicrobial; necrotizing enterocolitis; neonate; sepsis; surgical prophylaxis; urinary tract infection; ventilator-associated pneumonia.

Copyright © 2022 Ting, Autmizguine, Dunn, Choudhury, Blackburn, Gupta-Bhatnagar, Assen, Emberley, Khan, Leung, Lin, Lu-Cleary, Morin, Richter, Viel-Thériault, Roberts, Lee, Skarsgard, Robinson and Shah.

Publication types

Review