Reducing unnecessary antibiotic use in the neonatal intensive care unit (SCOUT): a prospective interrupted time-series study

Cantey, Joseph B.; Wozniak, Phillip S.; Pruszynski, Jessica; Sánchez, Pablo J.

doi:10.1016/s1473-3099(16)30205-5

Cited by 204 publications

(216 citation statements)

References 30 publications

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“…This study supports antimicrobial stewardship efforts to reduce inappropriate use 7. Additional studies are needed to evaluate if efforts to refine and reduce antibiotic utilisation can improve neonatal outcomes in very low birthweight infants.…”

Section: Implications For Practicesupporting

confidence: 63%

Antibiotic utilisation in very low birth weight infants without sepsis or necrotising enterocolitis is associated with multiple adverse outcomes

Roberts

Patel

2017

Evid Based Med

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Section: Implications For Practicesupporting

confidence: 63%

Antibiotic utilisation in very low birth weight infants without sepsis or necrotising enterocolitis is associated with multiple adverse outcomes

Roberts

Patel

2017

Evid Based Med

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“…It has also been shown that CRP level is not an indicator of early onset neonatal sepsis or bacteremia . Although it is difficult to determine a clear management strategy for culture‐negative early onset neonatal sepsis, the current recommendation is that neonates with elevated CRP in umbilical cord blood may not need antimicrobials for >48 h if the blood culture is negative . In the present study and in previous studies, the number of neonates who need antimicrobial treatment for >48 h is small .…”

Section: Discussioncontrasting

confidence: 49%

Elevated C‐reactive protein in umbilical cord blood: Neonatal case review

Kitano

Takagi²,

Arai³

et al. 2019

Pediatrics International

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Background C‐reactive protein (CRP) has limited placental transportability. Relying on CRP level in umbilical cord blood alone is an inaccurate way to predict early onset neonatal sepsis, and we retrospectively reviewed the clinical courses of neonates with elevated CRP in umbilical cord blood. Methods This study was a retrospective case review of neonates with elevated CRP in umbilical cord blood (>0.5 mg/dL) in the Nara Prefecture General Medical Center, Nara, Japan between February 2013 and August 2017. We investigated the association of maternal and neonatal factors with neonatal clinical course. Then, we compared the cases of neonates with and without elevated CRP in umbilical cord blood. Results The subjects consisted of a total of 22 neonates with elevated CRP in umbilical cord blood and 344 neonates without elevated CRP in umbilical cord blood. Of the 22 neonates with elevated CRP, 18 had some symptoms of sepsis at birth, but the symptoms of 85% of the symptomatic patients resolved ≤24 h after birth. Two neonates with elevated CRP in umbilical cord blood had bacteremia, and they had poor prognoses. Elevated CRP in umbilical cord blood was associated with length of antimicrobials (P = 0.021), immature/total neutrophil ratio (P = 0.017), and pathological chorioamnionitis (CAM; P = 0.028) on multivariable logistic regression analysis. Conclusion Elevated CRP in umbilical cord blood was associated with pathological CAM. Most symptoms of sepsis resolved <24 h after birth.

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“…Overuse of antibiotics has implications for patient safety including emerging multidrug‐resistant organisms, selection of pathogenic organisms, avoidable adverse drug reactions and increased healthcare costs . The IDSA guidelines do not make specific recommendations regarding AMS procedures in the neonatal unit; however, it has been suggested that these principles may be successfully applied to the NICU setting . Cantey et al.…”

Section: Introductionmentioning

confidence: 99%

“…Cantey et al. demonstrated a 27% reduction in total antibiotic use in the neonatal unit with prospective audit, targeted stewardship interventions and electronic ‘hard stops’ for empiric antibiotic treatment. This study provides an excellent model for AMS in the NICU and demonstrates that AMS interventions can produce a significant and measurable impact on antimicrobial use.…”

Section: Introductionmentioning

confidence: 99%