Research Article Audit of Antibiotic Prescribing Practices for Neonatal Sepsis and Measurement of Outcome in New Born Unit at Kenyatta National Hospital Priti Jagdishbhai Tank , Anjumanara Omar, and Rachel Musoke Department of Paediatrics and Child Health, School of Medicine, University of Nairobi, Kenya Correspondence should be addressed to Priti Jagdishbhai Tank; priti.tank1984@gmail.com Received 31 October 2018; Accepted 1 April 2019; Published 28 April 2019 Academic Editor: Alessandro Mussa Copyright © 2019 Priti Jagdishbhai Tank et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Neonatal sepsis is a leading cause of morbidity and mortality globally. A high index of suspicion is required since features of sepsis are nonspecifc. Auditing of antibiotic use is necessary to reduce misuse and minimise development of antibiotic resistance. Objectives. To assess the antibiotic prescribing practices in NBU at KNH against recommended Kenyan guidelines for neonatal sepsis. In addition, outcome within 7 days was described. Methods. Tis was a prospective audit of 320 neonates over a 2-month period at NBU of KNH. Data were collected using a structured questionnaire, stored in MS-EXCEL, and analysed using STATA. Results. Documentation of perinatal risk factors and clinical features at admission and at the time of change of antibiotics was very poor. Te rate of investigations to confrm infection was very low. Blood cultures were done only in 13 (4%) neonates on admission, while complete blood count and C reactive protein were done in 224 (70%) and 198 (62%), respectively. Appropriate antibiotics as per the Kenyan guidelines were prescribed in 313 (97.8%) of neonates on admission. However, these were not stopped at 48-72 hours for the 148 (53.62%) who had improved. Overall mortality was high in neonates at 80 (25%). Majority (55%) died within 48 hours. Mortality was high among preterm neonates; 70 (43.8%) died out of 160. Conclusion. Overall documentation and investigations to confrm infection was poor. Te continuation of antibiotics was inappropriate. Overall mortality was high especially in the frst 48 hours of admission. To improve documentation, availability of a checklist on admission is recommended. 1. Introduction According to Global Health Observatory data, 2.6 million neonates died in 2016. Te main causes of neonatal deaths are prematurity and low birth weight, infections, asphyxia, and birth trauma. Sepsis accounts for around one-third deaths in neonates worldwide [1]. Survivors of neonatal sepsis are at higher risk of neurodevelopmental impairment [2–5]. Neonatal sepsis usually has nonspecifc presentation, hence, delay in treatment, and especially initiation of efective antibiotic therapy results in serious consequences ranging from neurodevelopmental defcits to death [6]. Terefore, clinicians are urged to start empiric antibiotics to symp- tomatic neonates or neonates at high risk of sepsis while awaiting culture results [7]. Judicious use of antibiotics can be life-saving; however, both broad-spectrum antibiotics and prolonged treatment with empiric antibiotics can lead to development of antimicrobial resistance [8, 9]. Prolonged duration of antibiotics can be associated with adverse out- comes like necrotising enterocolitis, late-onset sepsis, and death [10]. Antibiotic prescribing practices should be evalu- ated periodically for its rational use to prevent emergence of resistance [8]. In an efort to reduce neonatal mortality rate, Ministry of Health of Kenya published Basic Paediatric Protocols (February-2016), which has guidelines for management of neonatal sepsis [11]. Training of health personnel on use of the Kenyan guidelines is done through the emergency triage and treatment plus (ETAT+) course. Adherence to guidelines in terms of choice and duration of antibiotics is very necessary in order to reduce development and spread of resistance in the hospital, as well as in the community [8, 12]. Antibiotics are Hindawi International Journal of Pediatrics Volume 2019, Article ID 7930238, 7 pages https://doi.org/10.1155/2019/7930238