Reduction of antibacterial use in patients with very low birth weight on German NICUs after implementation of a mandatory surveillance system. A longitudinal study with national data from 2013 to 2019

Kramer, Tobias Siegfried; Salm, Florian; Schwab, Frank J.; Geffers, Christine; Behnke, Michael; Gastmeier, Petra; Piening, Brar

doi:10.1016/j.jinf.2022.05.009

Cited by 2 publications

(3 citation statements)

References 39 publications

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“…A variation in use of broad-spectrum antibiotics, without obvious large differences in case mixes, is also reported from other studies. 6 , 26 Recently, a large US study reported a 4-fold variation in DOT for antibiotics per 1000 PD across NICUs with similar care complexity. 34 A potential overuse of third-generation cephalosporins or carbapenems increases selective pressure for multi-resistant Gram-negative organisms, and is associated with increased risk for invasive candidiasis.…”

Section: Discussionmentioning

confidence: 99%

“… 52 , 53 However, these commensal bacteria rarely cause fulminant sepsis, but vancomycin is frequently used as empirical therapy. 1 , 8 , 26 Indiscriminate use of vancomycin has been linked to the emergence of vancomycin-resistant organisms. 54 Some studies also report that vancomycin has a higher nephrotoxic and ototoxic potential in preterm infants compared with β-lactams, 55–57 whereas others do not report increased risk of toxicity.…”

Section: Discussionmentioning

confidence: 99%

“…Antibiotic exposure within each health region is presented as days of treatment (DOT) per 1000 patient days (PD). 26 We present data on DOT for any antibiotic therapy per 1000 PD, and data on DOT for specific antibiotic groups per 1000 PD. Since a combination of different antibiotic groups is often used, the cumulative days of DOT for the specific antibiotic groups per 1000 PD will exceed the DOT for any antibiotic per 1000 PD.…”

Section: Methodsmentioning

confidence: 99%

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Variation in antibiotic consumption in very preterm infants—a 10 year population-based study

Huncikova,

Stensvold,

Øymar

et al. 2023

Journal of Antimicrobial Chemotherapy

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Objectives Wide variations in antibiotic use in very preterm infants have been reported across centres despite similar rates of infection. We describe 10 year trends in use of antibiotics and regional variations among very preterm infants in Norway. Patients and Methods All live-born very preterm infants (<32 weeks gestation) admitted to any neonatal unit in Norway during 2009–18 were included. Main outcomes were antibiotic consumption expressed as days of antibiotic therapy (DOT) per 1000 patient days (PD), regional variations in use across four health regions, rates of sepsis and sepsis-attributable mortality and trends of antibiotic use during the study period. Results We included 5296 infants: 3646 (69%) were born at 28–31 weeks and 1650 (31%) were born before 28 weeks gestation with similar background characteristics across the four health regions. Overall, 80% of the very preterm infants received antibiotic therapy. The most commonly prescribed antibiotics were the combination of narrow-spectrum β-lactams and aminoglycosides, but between 2009 and 2018 we observed a marked reduction in their use from 100 to 40 DOT per 1000 PD (P < 0.001). In contrast, consumption of broad-spectrum β-lactams remained unchanged (P = 0.308). There were large variations in consumption of vancomycin, broad-spectrum β-lactams and first-generation cephalosporins, but no differences in sepsis-attributable mortality across regions. Conclusions The overall antibiotic consumption was reduced during the study period. Marked regional variations remained in consumption of broad-spectrum β-lactams and vancomycin, without association to sepsis-attributable mortality. Our results highlight the need for antibiotic stewardship strategies to reduce consumption of antibiotics that may enhance antibiotic resistance development.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Variation in antibiotic consumption in very preterm infants—a 10 year population-based study

Huncikova,

Stensvold,

Øymar

et al. 2023

Journal of Antimicrobial Chemotherapy

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Current Status and Issues of Infection Control in the Neonatal Intensive Care Units

Kim

2023

Korean J healthc assoc Infect Control Prev

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Very-low-birthweight infants (VLBWIs) are at increased risk of developing healthcare-acquired infections because of their immunological immaturity and the frequent use of invasive procedures. Healthcare-acquired infections are associated with increased length of stay, mortality, and significant morbidities in VLBWIs. Numerous issues with infection control in Korea's neonatal intensive care units (NICUs) have come to light as a result of the Ewha Womans University Mokdong Hospital incident on December 16, 2017, such as the shortages in manpower and facilities and the lack of standardized protocols and systemic supervision by the infection control tower. Although many issues have been improved in recent years, the shortage and considerable center-to-center disparity of manpower, including well-trained neonatal nurses and neonatologists for effective infection control in the NICUs, still remain unresolved. This study reviewed the current status and several issues of infection control in the NICUs in Korea, focusing on structural factors such as the shortage and center-to-center disparity of medical personnel.

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Reduction of antibacterial use in patients with very low birth weight on German NICUs after implementation of a mandatory surveillance system. A longitudinal study with national data from 2013 to 2019

Cited by 2 publications

References 39 publications

Variation in antibiotic consumption in very preterm infants—a 10 year population-based study

Variation in antibiotic consumption in very preterm infants—a 10 year population-based study

Current Status and Issues of Infection Control in the Neonatal Intensive Care Units

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