Antibio-gouvernance en néonatalogie

Abstract

Rational use of antibiotic has become a national and international health priority to fight against the emergence of multiresistant bacteria. Neonates are particularly exposed to antibiotic treatments because of their high susceptibility to severe infection and the lack of specificity of sepsis signs that make diagnosis difficult. This population is also particularly susceptible to microbiota disruption due to antibiotic treatment. Implementation of antibiotic stewardship in neonate is then an urgent need. According to a literature review, principles of antibiotic stewardship implementation in neonate are based on: (i) a multidisciplinary team comprising infectious disease specialists and aware of neonatal specificities (diagnosis, bacterial epidemiology, pharmacology) ; (ii) clear and easy-to-evaluate goals discussed a priori with neonatologists ; (iii) short-term assessment of the impact on antibiotic consumption and antimicrobial resistance ; (iv) enablement of the healthcare professionals within the ward to enhance the sustainability and (v) support from the institution.