Evaluation of Rational Antibiotic Use in Neonatology: The Angre University Hospital Experience

Abstract

Introduction : Neonatal mortality is largely driven by preventable conditions, including maternal-fetal bacterial infections, which frequently require antibiotic therapy. Optimizing antibiotic use in neonatal care is therefore a major public health priority, particularly in low- and middle-income settings. This study aimed to describe antibiotic utilization patterns and assess prescribing practices in the neonatal unit of Angre University Hospital, Côte d’Ivoire. Method s: A prospective descriptive study was conducted among neonates admitted to the neonatal unit between November 1, 2022, and January 31, 2023. Data collected included demographic and clinical characteristics, indications for admission, and assessment of infectious risk. Antibiotic utilization pressure and compliance of prescribing practices with established clinical guidelines were evaluated. Results : The majority of neonates were admitted for suspected early-onset neonatal bacterial infection. A male predominance was observed, with more than half of the deliveries performed by cesarean section and a considerable proportion of neonates presenting with APGAR scores below 6. Antibiotics were the most frequently prescribed medications, with the cefotaxime-gentamicin combination being the most commonly used regimen. Overall, 34.2% of antibiotic prescriptions did not meet predefined relevance criteria, mainly because the treatment had not been reassessed or adjusted based on available blood culture results. Bacteremia was microbiologically confirmed in fewer than one-third of cases, and staphylococci were the predominant pathogens isolated. Conclusion : In neonatology, where patients are highly vulnerable to infections, rational and guideline-adherent antibiotic use is essential to ensure effective treatment while minimizing the risk of antimicrobial resistance.