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Improving antibiotic prescribing in neonatal units: time to act
  1. Alison Bedford Russell1,
  2. Mike Sharland2,
  3. Paul T Heath2
  1. 1Neonatal Unit, Birmingham Women's NHS Foundation Trust, Birmingham, UK
  2. 2Paediatric Infectious Diseases Unit, St George's Hospital, London, UK
  1. Correspondence to Alison Bedford Russell, Neonatal Unit, Birmingham Women's NHS Foundation Trust, Birmingham B15 2TG, UK; alison.bedfordrussell{at}


Antibiotics are increasingly prescribed in the peripartum period, for both maternal and fetal indications. Their effective use can be life-saving, however, injudicious use drives antibiotic resistance and contributes to the development of abnormal faecal flora and subsequent immune dysregulation. Neonatal units are a high risk area for the selection and transmission of multi-resistant organisms. Very few new antibiotics with activity against Gram-negative bacteria are under development, and no significantly new Gram-negative antibiotics will be available in the next decade. This review seeks to summarise current practice, and suggests restrictive antibiotic strategies based on epidemiological data from recently published UK neonatal infection surveillance studies.

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  • Competing interests PTH coordinates the neonatal infection surveillance system (neonIN), and ABR contributes data to this database. MS is chairman of the iCAP Group (Improving Antibiotic Prescribing in Primary Care) and the deputy Chair of ARHAI – the DH Advisory Committee Antibiotic Resistance and Healthcare Associated Infection.

  • Provenance and peer review Commissioned; externally peer reviewed.