Grant: Project Grant

Infections are one of the most prevalent threats to infants who are born prematurely. Antibiotics have been developed to kill germs or stop their growth and are the most commonly prescribed drugs in neonatal intensive care units (NICUs). However, antibiotics are not always prescribed optimally, and their overuse can result in drug resistance (reduced effectiveness), which can lead to serious problems in infants. We know little about how often broad-spectrum antibiotics (i.e. antibiotic that acts against a wide range of disease-causing bacteria) are used and about how many infants have multidrug-resistant (MDR) bacteria (i.e. resistant to multiple antibiotics) presented in their body across Canadian NICUs. Unlike in adults, there is lack of consensus on the optimal interventions used to improve and measure the appropriate use of antimicrobials in infants. In this study, we wish to determine how frequently broad-spectrum antibiotics are used in daily care and how often MDR bacteria are encountered among premature infants, with a birth weight <1.5 kg. A national surveillance program, called the Canadian Neonatal Network (CNN), has been conducted in the past two decades to study the outcomes of all infants admitted to NICUs across Canada. Our study will gather data from the CNN regarding antibiotic use in each infant and the presence of drug resistance if infection exists. We can also study whether particular attributes (risk factors) predispose an infant to resistant infections. The information that will be obtained from this study will help each centre compare their own treatment standards with those of other centres ('benchmarking'), and can allow us to develop specific national strategies to reduce unnecessary antibiotic use ('antimicrobial stewardship') in the future.