Antibiotic stewardship in the neonatal intensive care unit and prevention of antimicrobial resistance.

Antimicrobial resistance is an evolving threat to infants admitted to the neonatal intensive care unit. Antibiotic-resistant organisms may colonize infants, cause infections, or contribute to nosocomial outbreaks, and are associated with infant morbidity and mortality. As microorganisms continue to acquire resistance to available antimicrobials, infants become at risk of therapeutic failure. One key strategy to prevent the development of antimicrobial resistance is through antimicrobial stewardship to optimize antimicrobial use. This review starts with an overview of neonatal sepsis and drivers of antimicrobial resistance. It subsequently discusses strategies to address and minimize the burden and transmission of antibiotic-resistance organisms as well as implement antimicrobial stewardship programs in the neonatal intensive care unit.