Principles and Strategies of Antimicrobial Stewardship in the Neonatal Intensive Care Unit

Sameer J. Patel, Lisa Saiman*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

75 Scopus citations


The judicious use of antibiotics is an important means to limit the emergence of antibiotic-resistant organisms. Although specific guidelines for neonates are often lacking, antibiotic stewardship principles can be applied to the neonatal intensive care unit. Principles include accurately identifying patients who need antibiotic therapy, using local epidemiology to guide the selection of empiric therapy, avoiding agents with overlapping activity, adjusting antibiotics when culture results become available, monitoring for toxicity, and optimizing the dose, route, and duration of therapy. Neonatal intensive care units should develop interdisciplinary antimicrobial stewardship teams with the support of their institutions. Prescriber audit and feedback, as well as preauthorization and formulary restriction of selected antibiotics, are recommended antimicrobial stewardship interventions. Ancillary strategies include education and computerized decision support. Metrics to evaluate antimicrobial stewardship programs should include measurements of patient safety and quality, such as rates of adverse drug events, and appropriate dosing and timing of perioperative prophylaxis.

Original languageEnglish (US)
Pages (from-to)431-436
Number of pages6
JournalSeminars in Perinatology
Issue number6
StatePublished - Dec 2012


  • Antibiotic resistance
  • Antibiotic stewardship
  • Patient safety

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology


Dive into the research topics of 'Principles and Strategies of Antimicrobial Stewardship in the Neonatal Intensive Care Unit'. Together they form a unique fingerprint.

Cite this