Reducing antibiotic exposure in suspected neonatal sepsis

Grant, C. H. et al. (2018) Reducing antibiotic exposure in suspected neonatal sepsis. Clinical Pediatrics, 57(1), pp. 76-81. (doi: 10.1177/0009922816689673) (PMID:28155332)

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Abstract

Prolonged antibiotic therapy is associated with antimicrobial resistance and increased mortality in preterm infants. We evaluated the impact of an automatic stop order (ASO) and C-reactive protein (CRP) on the duration of antibiotics and level of intervention in infants screened for early-onset sepsis who had negative cultures. We introduced an ASO for low-risk infants, then, consequently, for all infants treated for suspected sepsis. We subsequently introduced a single CRP measurement at 36 hours. Between 2011 and 2014, 4 time periods were studied, at baseline and after each intervention. The proportion of infants receiving ≤48 hours of antibiotics increased from 19% to 72.5% (P < .0001), whereas that of infants receiving avoidable doses (>48 hours and <5 days) fell from 50% to 0.8% (P < .0001). The use of an ASO decreased the proportion receiving avoidable doses from 26/92 (28.3%) to 9/293 (3.1%); P < .0001. There was a reduction in lumbar punctures performed, from 35% to 20%; P = .015.

Item Type:Articles
Keywords:Pediatrics, perinatology, and child health.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Grant, Dr Christopher
Authors: Grant, C. H., Arnott, A., Brook, T., Horne, A., Hurst, W., Kelly, S., Lang, C., Payne, M., Pert, H., Sparrow, S., Dokubo, P. A., Bee, N., Gibbs, R., and Becher, J.-C.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Clinical Pediatrics
Publisher:SAGE
ISSN:0009-9228
ISSN (Online):1938-2707
Published Online:03 February 2017

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