Antibiotic Stewardship in the Neonatal Intensive Care Unit: Effects of an Automatic 48-Hour Antibiotic Stop Order on Antibiotic Use

Journal of the Pediatric Infectious Diseases Society
Maria Corazon AstorgaPamela J Kling

Abstract

Meeting antibiotic stewardship goals in the neonatal intensive care unit (NICU) is challenging because of the unique nature of newborns and the lack of specificity of clinical signs of sepsis. Antibiotics are commonly continued for 48 hours pending culture results and clinical status. The goal of this study was to examine if the implementation of a 48-hour automatic stop (autostop) order during NICU admissions would decrease antibiotic use at UnityPoint Health-Meriter. An observational double-cohort study was performed in a level 3 NICU. Antibiotic use was evaluated before and after the autostop initiative. The admission order set included 48 hours of ampicillin and gentamicin coverage. After the autostop initiation, total doses given per patient decreased by 35% and doses per patient-day decreased by 25% (P < .0001). The greatest effect was a 66% decrease in the use of vancomycin, an antibiotic not included in the admission order set. Providers proactively continued antibiotics for infants in whom they had high suspicion for sepsis and in those with positive blood or cerebral spinal fluid culture results. An admission-order autostop was highly effective at decreasing antibiotic usage with no doses intended for a pathogen misse...Continue Reading

References

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Citations

Jan 9, 2020·Antimicrobial Resistance and Infection Control·D DonàM Sharland
May 8, 2020·The Pediatric Infectious Disease Journal·Michael W KuzniewiczKaren M Puopolo
Mar 15, 2020·Journal of the Pediatric Infectious Diseases Society·Dustin D FlanneryKaren M Puopolo
May 10, 2020·Antimicrobial Resistance and Infection Control·D DonàM Sharland
Apr 4, 2021·Antibiotics·Ioannis Kopsidas Preventing Hospital-Acquired Infections In Greece PHiG Investigators
Jun 10, 2021·Journal of Perinatology : Official Journal of the California Perinatal Association·Neetu Singh, James E Gray
Dec 4, 2020·Neonatology·Polona RajarKirsti Haaland
Nov 24, 2021·Pediatrics·Håkon Stangeland MundalKetil Størdal

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