Journal article
Reduction of Overall Antibiotic Utilization Rate in a Level IV Neonatal Intensive Care Unit
Pediatrics (Evanston), v 155(3)
01 Mar 2025
PMID: 39999320
Abstract
Antibiotics are the most frequently prescribed pharmacologic agents in the neonatal intensive care unit (NICU). Antibiotic treatment for suspected or culture-negative sepsis surpasses that for culture-proven infection. Therefore, we sought to reduce our overall antibiotic utilization rate (AUR), defined by total antibiotic days per 1000 patient days (DOT/1000-PD), by 20% within a 4-year period (by December 2023).
A multidisciplinary team was convened to develop an antibiotic stewardship quality improvement initiative in our 39-bed level IV NICU. Consensus guidelines for antibiotic duration for common indications were developed. Interventions included educational sessions, antibiotic stop dates, and antibiotic necessity documentation in the electronic health record to standardize provider justification for antibiotic prescription and duration.
A total of 552 infants were included in the analysis, 137 in the baseline and 415 in the postintervention period. Overall AUR decreased by 50% from 278 to 140 DOT/1000-PDs. AUR related to culture-negative sepsis diagnoses decreased by 64% from 22 to 8 DOT/1000-PDs. The percent of antibiotic therapy reinitiation within 2 weeks remained unchanged.
Implementation of NICU antibiotic consensus guidelines supported by evidence-based education on culture-negative sepsis diagnosis can effectively reduce antibiotic use in a safe manner, despite a heterogenous, high acuity, level IV NICU population. Multidisciplinary team support and standardization of antibiotic justification in the electronic health record can be coupled to reinforce compliance with established guidelines to promote long-lasting antibiotic reduction.
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Details
- Title
- Reduction of Overall Antibiotic Utilization Rate in a Level IV Neonatal Intensive Care Unit
- Creators
- Reema Paul - Department of Pediatrics, St. Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, PennsylvaniaDipen Vyas - University of Mississippi Medical CenterVilmaris Quinones Cardona - Drexel UniversityMargaret Gilfillan - Drexel UniversityMegan Young - St. Christopher's Hospital for ChildrenKimberly Pough - St. Christopher's Hospital for ChildrenAlison J Carey - Drexel University
- Publication Details
- Pediatrics (Evanston), v 155(3)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics
- Scopus ID
- 2-s2.0-85219502513
- Other Identifier
- 991022032173204721