Antibiotic use among Low Birth Weight newborns in Low Resource Settings: a retrospective study in a rural regional hospital in Tanzania

Antibiotic use is very common in newborns in all neonatal intensive care units (NICUs). Neonatal sepsis, particularly in low birth weight (LBW) and very low birth weight (VLBW) infants, remains a major cause of infant morbidity and mortality. On one hand, the use of antibiotics has significantly reduced mortality due to sepsis and infections in general; on the other hand, it has been found that the overuse or misuse of antibiotics in newborns is associated with various adverse outcomes. Moreover, the excessive use of these medications can disrupt neonatal microbial flora and promote colonization by multidrug-resistant bacteria. In resource-limited settings, such as many African countries, the lack of availability of effective diagnostic tools makes the management of newborn infections even more difficult and this often leads to incorrect use of antibiotic treatments. In response to this concern, antimicrobial stewardship programs have been implemented all over the world, aiming to minimize unnecessary antibiotic exposure without increasing the risk of sepsis.The purpose of this study is to assess the prevalence of antibiotic use among LBW newborns at high and low risk of infection admitted to a rural hospital in Tanzania. Additionally, the research examines the differences in outcomes according to antibiotic use among the two groups and between neonates at low risk of infection who received antibiotics and those who did not.