Volume 12, Issue 3 (2026)
Pharm Biomed Res 2026, 12(3): 0-0 |
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Shadfar F, Salehifar E, Shadfar L. Antibiotic strategies in Neonatal Intensive Care: A comprehensive review. Pharm Biomed Res 2026; 12 (3)
URL: http://pbr.mazums.ac.ir/article-1-742-en.html
URL: http://pbr.mazums.ac.ir/article-1-742-en.html
1- Assistant Professor of Clinical Pharmacy, Faculty of Pharmacy, Urmia University of Medical Science, Iran.
2- Professor of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical, Iran.
3- Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran.
2- Professor of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical, Iran.
3- Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran.
Abstract: (3 Views)
Background: Antibiotics are among the most frequently prescribed therapies in neonatal intensive care units (NICUs), largely due to the high susceptibility of neonates to infection and the nonspecific clinical manifestations of neonatal sepsis. Although early empirical antibiotic therapy is often essential and lifesaving, increasing evidence suggests that inappropriate initiation, prolonged duration, and excessive use of broad-spectrum antibiotics may contribute to antimicrobial resistance, disruption of the neonatal microbiome, and unfavorable short- and long-term outcomes.
Objectives: This review aims to synthesize current evidence on antibiotic utilization in NICUs and to identify key challenges in optimizing their use.
Method: A comprehensive narrative review was conducted by searching electronic databases including PubMed, Scopus, and Web of Science. Articles published in English that addressed antibiotic utilization, indications for therapy, duration of treatment, and outcomes in neonates admitted to NICUs were reviewed.
Results: Findings from the reviewed literatures indicate that a large proportion of neonates admitted to NICUs receive antibiotic therapy, with the highest exposure observed among preterm and low-birth-weight infants. Empirical antibiotics are frequently initiated for suspected early- and late-onset sepsis, often in the absence of microbiological confirmation, leading to unnecessary prolonged exposure. Such practices have been linked to increased risks of antimicrobial resistance, necrotizing enterocolitis, invasive fungal infections, and persistent alterations in gut microbiota.
Conclusion: Antibiotic use in NICUs remains widespread and heterogeneous across institutions. Strengthening antibiotic stewardship interventions, emphasizing evidence-based guidelines, and promoting timely de-escalation or discontinuation of therapy are crucial to improving neonatal outcomes and mitigating the growing threat of antimicrobial resistance.
Objectives: This review aims to synthesize current evidence on antibiotic utilization in NICUs and to identify key challenges in optimizing their use.
Method: A comprehensive narrative review was conducted by searching electronic databases including PubMed, Scopus, and Web of Science. Articles published in English that addressed antibiotic utilization, indications for therapy, duration of treatment, and outcomes in neonates admitted to NICUs were reviewed.
Results: Findings from the reviewed literatures indicate that a large proportion of neonates admitted to NICUs receive antibiotic therapy, with the highest exposure observed among preterm and low-birth-weight infants. Empirical antibiotics are frequently initiated for suspected early- and late-onset sepsis, often in the absence of microbiological confirmation, leading to unnecessary prolonged exposure. Such practices have been linked to increased risks of antimicrobial resistance, necrotizing enterocolitis, invasive fungal infections, and persistent alterations in gut microbiota.
Conclusion: Antibiotic use in NICUs remains widespread and heterogeneous across institutions. Strengthening antibiotic stewardship interventions, emphasizing evidence-based guidelines, and promoting timely de-escalation or discontinuation of therapy are crucial to improving neonatal outcomes and mitigating the growing threat of antimicrobial resistance.
Type of Study: Review article |
Subject:
Clinical Pharmacy
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