Analysis of Anti-infective Drug Utilization by Type of Infectious Disease in Korean Neonatal Intensive Care Units

Background : Antimicrobial stewardship programs (ASPs) in neonatal intensive care unit (NICU) ensures appropriate antibiotic use and enhance patient outcomes.This study aimed to support the implementation of ASPs for neonates by analyzing the use of anti-infective drugs according to types of neonatal infections in NICUs nationwide.Methods : Data from Korean NICU health insurance claims were analyzed, focusing on cases involving both NICU hospitalization and anti-infectives prescriptions for seven major neonatal infectious diseases: pneumonia, sepsis, meningitis, urinary tract infection, necrotizing enterocolitis, fungal infections, and viral infections.The analysis included the list of anti-infectives, the number of anti-infective prescriptions, days of therapy (DOT) of anti-infectives per claim, and the number of anti-infectives used per claim for each type of infectious disease. Results :The infection with the longest median DOT per claim was fungal infection (median 31 days, interquartile range:16-58 days).The median DOT per claim for necrotizing enterocolitis was also long at 24 days compared to 14 days for sepsis, 16 days for pneumonia, 14 days for meningitis, 14 days for urinary tract infections, and 12 days for viral infections.Analysis of the number of anti-infectives used per claim revealed that fungal infections averaged 4.18 2.18 per claim and that necrotizing enterocolitis averaged 3.73 1.89 per claim, higher than those for other infections.In the analysis of sepsis and meningitis claims, the top seven anti-infectives were cefotaxime, ampicillin, ampicillin/sulbactam, : -49 - 60% . 1)-4) , , , . 5) , . 6),7) (antimicrobial stewardship program, ASP) . 8),9) ASP . 10) ASP 23% , 15% . 11) ASP , 2),12) . ASP