Banca de DEFESA: FRANCISCO CLÉBISON CHAVES LOPES

PROFILE OF ANTIMICROBIAL USE IN NEONATAL INTENSIVE CARE UNITS: A SCOPE REVIEW

Anti-Infectives. Neonatal Intensive Care Units. Medication Utilization.

Newborns are particularly susceptible to infections due to their immature immune systems, exacerbated by factors such as invasive procedures, length of hospital stay, and low birth weight. Consequently, studies investigating medication usage patterns in Neonatal Intensive Care Units suggest that systemic anti-infective agents constitute the most commonly used class of medications. The population's susceptibility, lack of consensus in definitions, and variability in etiological agents across regions pose challenges in formulating global recommendations, leading to diverse management approaches for neonatal infections. Therefore, this study aims to delineate the profile of antimicrobial usage in Neonatal Intensive Care Units. It involves a scoping review conducted in accordance with the methodology proposed by the Joanna Briggs Institute (JBI). The following databases will be included: LILACS via the Virtual Health Library; BASIS; MEDLINE/PubMed via the National Library of Medicine; Scientific Electronic Library Online (SciELO) via Web of Science; Web of Science, and Scopus. To identify gray literature, the following digital repositories will be consulted: Repositório Científico de Acesso Aberto de Portugal (RCAAP), Portal Theses Canada, Biblioteca digital de Tese e dissertação (BDTD - Ibict), Catálogo de Teses e Dissertações da CAPES, Red latinoamericana de repositorios de acceso abierto (La Referencia), Academic Archive Online (DIVA). The search will employ descriptors combined with the Boolean operators “OR” and “AND,” relevant to the PCC acronym: population, concept, and context. Identified studies will be uploaded to the Rayyan app, and duplicates will be eliminated. Two independent reviewers will carry out study selection and data extraction. A total of 4,029 articles were identified, of which 39 were included in the final review. The most common method to measure antimicrobial consumption was Days of Therapy (DOT). Among antimicrobials, antibacterials were the most studied. The classes of penicillins, cephalosporins and glycopeptides were mentioned in all studies. Antimicrobials were used off-label in relation to dose, administration interval, indication and age.