التفاصيل البيبلوغرافية
العنوان: |
Optimizing antibiotic use for early onset sepsis: A tertiary NICU experience. |
المؤلفون: |
Arora, V., Strunk, D., Furqan, S.H., Schweig, L., Lefaiver, C., George, J., Prazad, P. |
المصدر: |
Journal of Neonatal - Perinatal Medicine; 2019, Vol. 12 Issue 3, p301-312, 12p, 1 Diagram, 1 Chart, 1 Graph |
مصطلحات موضوعية: |
PREMATURE infants, ENTEROCOLITIS, SEPSIS, NOSOCOMIAL infections, NEONATAL sepsis, ANTIBIOTICS |
الشركة/الكيان: |
CENTERS for Disease Control & Prevention (U.S.) |
مستخلص: |
BACKGROUND: Neonatal antibiotic use is associated with a greater risk of nosocomial infection, necrotizing enterocolitis, and mortality. It can induce drug-resistant pathogens that contribute to increased neonatal morbidity/mortality, healthcare costs, and length of stay. Prior to the antibiotic stewardship program, decisions to obtain blood cultures and empiric antibiotics for possible Early-onset Sepsis (EOS) in late preterm and term infants upon NICU admission were provider-dependent rather than algorithm-based. We aimed to decrease empiric antibiotic prescription from 70% to 56% (20% decrease) in infants ≥34 weeks gestation admitted to the NICU. METHODS: The stewardship initiative comprised the following practice changes: (1) use of the Neonatal Sepsis Risk Calculator (SRC); and (2) a 36-hour time-out for prescribed empiric antibiotics. Data was retrospectively collected and analyzed for inborn infants pre-intervention (January 2015–December 2015; n = 263) and post-intervention (August 2016–September 2017; n = 279). Data regarding compliance with the new antibiotic guideline were collected and disseminated to the team every week. Overlap between CDC guidelines and calculator recommendations were studied. RESULTS: Pre-and post-intervention outcomes were analyzed using chi-square tests. There was a significant post-intervention reduction in the rate of both antibiotic prescriptions (29.4% decline; 70.3% vs. 49.6%; p < 0.001) and sepsis evaluations (24.3% decline; 90.9% vs. 68.8%; p < 0.001). No difference (p = 0.271) in culture-positive EOS cases was observed. There was 92% overlap in blood culture recommendations and 95% overlap between antibiotic recommendations when current CDC guidelines were compared to the SRC. CONCLUSION: A significant reduction in antibiotic use and sepsis evaluations was achieved for late preterm and term infants upon NICU admission. No clinical deterioration occurred in post-intervention infants who did not receive antibiotics. There is significant overlap between CDC guidelines and SRC recommendations. [ABSTRACT FROM AUTHOR] |
|
Copyright of Journal of Neonatal - Perinatal Medicine is the property of IOS Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
قاعدة البيانات: |
Complementary Index |