Antimicrobial Stewardship in the NICU

Cantey, Joseph B.; Patel, Sameer

doi:10.1016/j.idc.2014.01.005

Cited by 107 publications

(113 citation statements)

References 80 publications

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“…DOT per 1,000 PD was used as our main outcome measure, but the optimal metric for antibiotic stewardship has not been defined. 4,35 Our primary focus was on improving antibiotic prescription, but we did not delve deeper into whether antimicrobial prescription practices are affected by specific conditions. We cannot prove that ASP implementation was directly responsible for any of the changes observed.…”

Section: Discussionmentioning

confidence: 99%

Implementation of an Antimicrobial Stewardship Program in a Neonatal Intensive Care Unit

Nzegwu

Rychalsky

Nallu

et al. 2017

Infect. Control Hosp. Epidemiol.

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objective. To evaluate antimicrobial utilization and prescription practices in a neonatal intensive care unit (NICU) after implementation of an antimicrobial stewardship program (ASP).design. Quasi-experimental, interrupted time-series study.setting. A 54-bed, level IV NICU in a regional academic and tertiary referral center.patients and participants. All neonates prescribed antimicrobials from January 1, 2011, to June 30, 2016, were eligible for inclusion.intervention. Implementation of a NICU-specific ASP beginning July 2012.methods. We convened a multidisciplinary team and developed guidelines for common infections, with a focus on prescriber audit and feedback. We conducted an interrupted time-series analysis to evaluate the effects of our ASP. Our primary outcome measure was days of antibiotic therapy (DOT) per 1,000 patient days for all and for select antimicrobials. Secondary outcomes included provider-specific antimicrobial prescription events for suspected late-onset sepsis (blood or cerebrospinal fluid infection at >72 hours of life) and guideline compliance.results. Antibiotic utilization decreased by 14.7 DOT per 1,000 patient days during the stewardship period, although this decrease was not statistically significant (P = .669). Use of ampicillin, the most commonly antimicrobial prescribed in our NICU, decreased significantly, declining by 22.5 DOT per 1,000 patient days (P = .037). Late-onset sepsis evaluation and prescription events per 100 NICU days of clinical service decreased significantly (P < .0001), with an average reduction of 2.65 evaluations per year per provider. Clinical guidelines were adhered to 98.75% of the time.conclusions. Implementation of a NICU-specific antimicrobial stewardship program is feasible and can improve antibiotic prescribing practices.

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Section: Discussionmentioning

confidence: 99%

Implementation of an Antimicrobial Stewardship Program in a Neonatal Intensive Care Unit

Nzegwu

Rychalsky

Nallu

et al. 2017

Infect. Control Hosp. Epidemiol.

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“…Con este fin, se han desarrollado protocolos de uso racional de antimicrobianos en distintos centros [21][22][23] , y se han promovido recomendaciones internacionales para lograr este propósito 24,25 . En el año 2012, la Sociedad Americana de Epidemiologia de la Salud (Society for Healthcare Epidemiology of America, SHEA), Sociedad Americana de Enfermedades Infecciosas (Infectious Diseases Society of America, IDSA) y la Sociedad Pediátrica de Enfermedades Infecciosas de América (Pediatric Infectious Diseases Society of America-PIDS) también publicaron recomendaciones relacionadas a este tema 26 .…”

Section: Artículo Originalunclassified

Estrategias para reducir infecciones, uso de antimicrobianos y sus efectos en una unidad de neonatología

Urzúa

Ferrés

García

et al. 2017

Rev. chil. infectol.

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“…1,2 Infection control measures such as hand hygiene have been emphasized for the prevention of neonatal sepsis, and appropriate antibiotic use strategies have been recommended according to each center's pathogenic epidemiology. 3,4 The patterns of the bacterial pathogens responsible for neonatal sepsis, however, have changed with developments in intensive care units. [5][6][7] The preterm birth rate continues to increase in most developed countries.…”

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confidence: 99%

Neonatal sepsis in a rapidly growing, tertiary neonatal intensive care unit: Trends over 18 years

Heo

Shin

Jung

et al. 2015

Pediatrics International

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The inborn admission rate for ELBW infants has increased significantly and is accompanied by improved survival and longer hospital stay. The incidence of neonatal sepsis, particularly in ELBW infants, has also increased, and CONS has emerged as a major pathogen. Central vascular catheters and prolonged hospitalization could be independent risk factors for the increased sepsis rate, particularly sepsis due to CONS.

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Antimicrobial Stewardship in the NICU

Cited by 107 publications

References 80 publications

Implementation of an Antimicrobial Stewardship Program in a Neonatal Intensive Care Unit

Implementation of an Antimicrobial Stewardship Program in a Neonatal Intensive Care Unit

Estrategias para reducir infecciones, uso de antimicrobianos y sus efectos en una unidad de neonatología

Neonatal sepsis in a rapidly growing, tertiary neonatal intensive care unit: Trends over 18 years

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