Bilu Bhageerathan Sreemathy1 , Sivaprasad Padmaja Sivasankara Menon2 , Arya Raveendran Pillai Vasantha Kumari3 , Anilkumar Valiyaparambil Damodaran4 , Anita Anurudhan5 , Anju Chempakasseril Mathew6 , Naushad Mohamed Sali7 , Sreeja Ambalaparambil8
BACKGROUND Early diagnosis and treatment of the newborns with suspected sepsis are essential to prevent severe and life-threatening complications. In this era of multidrug resistance, it is mandatory to avoid unnecessary use of antibiotics to treat non?infected neonates. METHODS A retrospective comparative study was conducted in the Special Newborn Care Unit, General Hospital, Ernakulam, Kerala, for a period of six months each for pre- and post- Sepsis Management Project [SMP] implementation. Empirical antibiotics started, duration of antibiotic usage, and length of stay in presumed and probable sepsis cases admitted, were analysed and compared. During presepsis management project period, manual method of blood culture technique was used. During post-sepsis management project implementation period, introduction of antibiotic guidelines, automated blood culture technique, and training on antibiotic stewardship program to clinicians, were done. RESULTS Average days for discharge in presumed and probable sepsis cases was reduced from 7.2 days to 5.4 days (P value < 0.05); that means reduction of 44 hours after implementation of the project. Rational usage of ampicillin and amikacin as the first line in presumed and probable sepsis cases increased from 80 % to 91 % and cefotaxime usage as first line antibiotic reduced from 18 % to 7 % after SMP implementation. CONCLUSIONS Rational usage of antibiotics in post-sepsis management project implementation period was due to a good adherence to the antibiotic guidelines by clinicians, introduction of automated blood culture, a good support from the microbiology lab and frequent training and awareness given to clinicians as a part of sepsis management project.
