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. 2025 Jan 24;25(1):60.
doi: 10.1186/s12887-025-05407-z.

Frequency and types of antibiotic usage in a referral neonatal intensive care unit, based on the world health organization classification (AwaRe)

Farzaneh Hematian  1 , Seyyed Mohammad Hassan Aletayeb  2 , Masoud Dehdashtian  3 , Mohammad Reza Aramesh  3 , Arash Malakian  3 , Mahboobeh Sadat Aletayeb  4
Affiliations

Frequency and types of antibiotic usage in a referral neonatal intensive care unit, based on the world health organization classification (AwaRe)

Farzaneh Hematian et al. BMC Pediatr. .

Abstract

Background: Excessive prescription of antibiotics in infants increases the risk of short-term and lifelong morbidity and mortality. Nonetheless, the use of antibiotics in neonatal intensive care units (NICUs) is significantly high. This is primarily because neonatologists are concerned about the fragile immune systems of newborns, their vulnerability to serious infectious diseases, and the challenge of accurately distinguishing between infectious and non-infectious conditions.

Method: A five-month cross-sectional prospective study was conducted in southwestern Iran's largest neonatal intensive care unit. This study aimed to evaluate the dose and duration of antibiotic therapy and identify the prescribing pattern of antibiotics based on the Access, Watch, and Reserve (AWaRe) classification recommended by the World Health Organization (WHO).

Results: Out of 502 examined patient files, antibiotics were prescribed for 483 neonates. The most common drug combinations were ampicillin and amikacin. The mean number and duration of antibiotic administration were 2.14 drugs and 7.78 days, respectively. 84.3% of infants received antibiotics for ten days or less. The mean course of antibiotic prescription for newborns was 1.1, and 83.1% of prescribed antibiotics were from the Access Group.

Conclusion: The antibiotic prescription rate was high in our study's department. Most neonates received two antibiotics in one course from the Access group.

Keywords: Antibiotics; Aware; Iran; Neonates.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The research was conducted with the approval of the Pediatrics Department and the Research Vice-Chancellor of Ahvaz University of Medical Sciences and in accordance with the World Medical Association Declaration of Helsinki. The data for this study was obtained from the patient’s hospital records immediately following their discharge. No diagnostic or therapeutic interventions were conducted during their hospital stays, and all patients’ personal information was kept entirely confidential. Written informed consent was obtained from the legal guardians before the neonate was enrolled. The Medical Ethics Committee of Ahvaz Jundishapur University of Medical Sciences provided the code IR.AJUMS.REC.1403.011 to authorize the initiation of this study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

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Fig. 1
Consort Diagram of hospitalized Neonates
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