Evolving Antibiotic Resistance in Neonatal Sepsis in a Tertiary Neonatal Care Unit in Eastern India: A Prospective Study

Abstract

Introduction: The Indian National Neonatology Forum (NNF) advises using ampicillin and gentamicin as the initial empirical antibiotics for treating neonatal sepsis. However, with the ongoing rise in antibiotic resistance among pathogens, there is a pressing need to update and review the current antibiotic protocols. Aims and Objectives: This study aims to describe the spectrum of antibiotic sensitivity pattern of common pathogens causing blood culture-positive neonatal sepsis and propose a uniform first-line empirical antibiotic against them. Methodology: The study was conducted in the Neonatal Intensive Care Unit (NICU) over a period of 2 years. A total of 100 inborn neonates, who had blood culture proven sepsis, were included in the study. The antibiotic susceptibility pattern against commonly used antibiotics like Ampicillin, Gentamicin, Piperacillin-tazobactam, Amikacin and Meropenem were analysed. Results: The most common organism to be isolated from blood culture was Klebsiella pneumoniae (32%). None of them were sensitive to Ampicillin, and only 43.75% were sensitive to Gentamicin. Instead, Piperacillin tazobactam had 50% sensitivity, and Amikacin had 81.25% sensitivity. Conclusion: The study highlights the changing trends of antibiotic sensitivity patterns and the high degree of resistance to the conventional Ampicillin–Gentamicin combination. Instead, Piperacillin tazobactam - Amikacin can be a better alternative choice of empirical antibiotic.