Evaluation of antimicrobial consumption in the neonatal population undergoing antimicrobial stewardship programmes: a systematic review

Abstract

Background: Indiscriminate use of antimicrobials in neonatal sepsis treatment contributes to consumption misuse, and the optimization of prescription programmes is encouraged as a way of reducing this inappropriate use.

Aim: To evaluate the impact of intervention programmes for adequate antimicrobial use (antimicrobial stewardship programmes) in consumption measurements of such drugs in neonatology.

Methods: The search for articles was performed in electronic databases and by manual search for citations in publications initially identified. Electronic databases searched were BVS (Virtual Health Library), Cochrane Library, Embase, MEDLINE/PubMed, SciELO, Scopus, and Web of Science. There was no date or period limit for inclusion of articles. The PICO question was defined as populations of neonates admitted to neonatal intensive care units undergoing an intervention programme to optimize antimicrobial therapy in relation to neonates not exposed to the programme and the outcome obtained in antimicrobials consumption.

Findings: The initial search in databases resulted in 1223 articles. Articles were screened and 16 original studies related to subject were selected, which conducted a quantitative approach to antimicrobials consumption for the population of interest. Most articles used days of therapy (DOT) as the main measure of antimicrobial consumption and have had a high-quality rating by Newcastle-Ottawa Scale. All studies were carried out in local hospitals at a single centre and most were in high-income countries.

Conclusion: Of all studies identified by the search, few evaluated antimicrobial consumption in neonatology. New studies are needed, and DOT was shown to be the most adequate metric to measure consumption.

Keywords: Antimicrobial consumption; Antimicrobial stewardship programme; Neonatology.