Abstract: Background：Antibiotics are a frequently used drug category in NICU. The Antibacterial Drug Management Project (ASP) can promote the rationalization of the use of antibiotics in NICU. Objective：To explore the effectiveness of implementing ASP to reduce the use of antibiotics in newborns with pneumonia. Design：Quality improvement research. Methods：This study focuses on infants with neonatal pneumonia and divides them into a control group and an intervention group before and after the implementation of ASP starting from January 1, 2019. The control group was treated with antibiotics selected by the attending physician based on empirical antimicrobial spectrum, and special pathogens or drugs were used after consultation with infectious disease physicians. The intervention group implemented NICU's characteristic ASP through the MDTASP team, which includes neonatologists, clinical pharmacists, infectious disease physicians, microbiology laboratory physicians, and radiologists. The MDTASP team conducted regular rounds, medication evaluations, and guidance on antibiotic use. When the sample size of the intervention group and the control group meet a 1∶1 ratio, inclusion will be terminated. Main outcome measures：Proportion of combined use of antibiotics in newborns with pneumonia. Results：From January 1, 2018 to June 30, 2018, 229 cases were retrospectively included in the control group, and from January 1, 2019 to May 30, 2019, 229 cases were prospectively included in the intervention group. There was no statistically significant difference between the two groups in terms of general information of the child and basic information of the mother. The proportion of combined use of antibiotics in the control group and intervention group was 24.5% (56/229) and 7.0% (16/229), respectively（χ2=26.367, P＜0.001). Compared with the intervention group, the days of antimicroial therapy was shortened from 12 (360) days to 8 (035) days (P＜0.001), and the length of hospital stay was shortened from 10 (733) days to 9 (546) days (P=0.005). There was no statistically significant difference in the proportion of necrotizing enterocolitis and death between the two groups after the use of antibacterial drugs. Conclusions：ASP can reduce the use of antimicrobial agents so as to decrease unnecessary antimicrobial exposure in neonatal department.

Key words: antimicrobial stewardship program, Neonatal pneumonia, Neonatal center, Multidisciplinary team, Antimicrobial combination