Evaluation of antibiotic stewardship among near-term and term infants admitted to a neonatal unit

作者全名："Feng, Kun; He, Yunyan; Liu, Weiqin; Zhang, Xinyin; Song, Ping; Hua, Ziyu"

作者地址："[Feng, Kun; He, Yunyan; Liu, Weiqin; Zhang, Xinyin; Hua, Ziyu] Chongqing Med Univ, Dept Neonatol,Chongqing Key Lab Pediat, Childrens Hosp,China Int Sci & Technol Cooperat B, Minist Educ,Key Lab Child Dev & Disorders,Natl Cl, 136 Zhongshan Er Rd, Chongqing 400014, Peoples R China; [Song, Ping] Chongqing Univ, Childrens Med Big Data Intelligent Applicat, Engn Res Ctr, Chongqing 400014, Peoples R China"

通信作者："Hua, ZY (通讯作者)，Chongqing Med Univ, Dept Neonatol,Chongqing Key Lab Pediat, Childrens Hosp,China Int Sci & Technol Cooperat B, Minist Educ,Key Lab Child Dev & Disorders,Natl Cl, 136 Zhongshan Er Rd, Chongqing 400014, Peoples R China."

来源：EUROPEAN JOURNAL OF PEDIATRICS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000875435700001

JCR分区：Q1

影响因子：3.6

年份：2022

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：Neonate; Antibiotic stewardship; Interrupted time series analysis; Quality improvement

摘要："To evaluate the safety and effectiveness of evidence-based antibiotic stewardship in a neonatal unit in China. The study period consisted of two phases, one retrospective (the baseline period, January to December 2018, and the transition period, January 2019 to August 2020) and one prospective intervention period (September 2020 to August 2021). During the prospective period, evidence-based antibiotic stewardship was applied to neonates with suspected infections, pneumonia, and culture-negative sepsis. The antibiotic stewardship included the observation form of neonatal infections, antibiotic therapy of no more than 48 h for suspected infections, and 5 days for pneumonia and culture-negative sepsis. The change in antibiotic use measured by days of therapy per 1000 patient-days between the baseline and intervention period was analyzed. Safety outcomes included reinitiation of antibiotics within 14 days, length of stay, occurrence of late-onset sepsis and necrotizing enterocolitis (Bell stage >= II), multidrug-resistant organism infections, and mortality. A total of 7705 neonates were enrolled during the baseline ( n = 4804) and the intervention periods (n = 2901). The total antibiotic usage during the baseline period was 771 days of therapy per 1000 patient-days, while that was 525 days of therapy per 1000 patient-days during the intervention period, indicating a 32% decrease in antibiotic consumption. No significant difference in safety outcomes was observed between the baseline and intervention period (P > 0.05), whereas the length of stay was longer during the intervention period (P < 0.001). Conclusion: The evidence-based antibiotic stewardship can safely and effectively reduce antibiotic use and shorten the duration of therapy in the neonatal unit."

基金机构：Clinical Research Project of Children's Hospital of Chongqing Medical University [YBXM 2019-007]

基金资助正文：This study was supported by grants from the Clinical Research Project of Children's Hospital of Chongqing Medical University (grant number YBXM 2019-007). The funder had no involvement in the preparation of data or the manuscript.