Antimicrobial Prescription Practices and Mortality in Neonates Admitted With Suspected Neonatal Sepsis at the Mboppi and Bonaberi Baptist Hospitals, Douala, Cameroon :a Cross-sectional Descriptive Study

Abstract

Background Neonatal sepsis is a significant contributor to morbidity and mortality globally. Neonates usually present with nonspecific signs, hence requires a high index of suspicion (1). For this reason, clinicians start empiric antibiotics in an attempt to improve outcomes. This has led to the misuse of antibiotics and under treatment in some cases of neonates with neonatal sepsis. Cameroon’s neonatal mortality rate is 26.2/1000 live births, with neonatal sepsis contributing 1/3rd to this mortality, no information exists on current practices in early-onset neonatal sepsis. These guidelines are non-existent, hence the need for our study. Objective: Our study's primary objective was to determine the proportion of neonates with EONS having appropriate antibiotic prescriptions at admission at two hospitals. As secondary objectives, we evaluated risk factors associated with appropriate prescription, Described the pattern of antimicrobial prescription based on the WHO classification of antimicrobials (AWaRe) and to Determine the in-hospital mortality in EONS. Study Design This was a cross-sectional descriptive study carried out at two hospitals: Mboppi and Bonaberi Baptist Hospitals in Cameroon from October 2021-febuary 2022. Methodology All records of neonates hospitalized during the study period were reviewed, an exit interview of mothers in postnatal and pediatric wards was undertaken, and those eligible for the study identified. Consent was obtained, and the neonate was enrolled in the study. Study identity number, age, sex, gestational age and birth weight were all noted in the demographic data. Data was extracted from patient files using a data abstraction tool. The participants were then monitored for 5 days to see any changes in the antibiotic. Results were recorded as alive or dead on the seventh day. Data analysis Data was cleaned and entered into an excel spreadsheet and transferred to SPSS version 22 for all statistical analysis. Results 33% of neonates had appropriate antimicrobial prescription on admission, the odds of getting an appropriate prescription were 1.5 higher in those who had chorioamnionitis .20% of neonates had been prescribed antibiotics in the reserve group and the in-hospital case fatality was 12%.