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Influence of Patient Characteristics on Antibiotic Use Rates Among Preterm Infants.
- Source :
-
Journal of the Pediatric Infectious Diseases Society [J Pediatric Infect Dis Soc] 2021 Mar 26; Vol. 10 (2), pp. 97-103. - Publication Year :
- 2021
-
Abstract
- Background: The antibiotic use rate (AUR) has emerged as a potential metric for neonatal antibiotic use, but reported center-level AURs are limited by differences in case mix. The objective of this study was to identify patient characteristics associated with AUR among a large cohort of preterm infants.<br />Methods: Retrospective observational study using the Optum Neonatal Database, including infants born from January 1, 2010 through November 30, 2016 with gestational age 23-34 weeks admitted to neonatal units across the United States. Exposures were patient-level characteristics including length of stay, gestational age, sex, race/ethnicity, bacterial sepsis, necrotizing enterocolitis, and survival status. The primary outcome was AUR, defined as days with ≥ 1 systemic antibiotic administered divided by length of stay. Descriptive statistics, univariable comparative analyses, and generalized linear models were utilized.<br />Results: Of 17 910 eligible infants, 17 836 infants (99.6%) from 1090 centers were included. Median gestation was 32.9 (interquartile range [IQR], 30.3-34) weeks. Median length of stay was 25 (IQR, 15-46) days and varied by gestation. Overall median AUR was 0.13 (IQR, 0-0.26) and decreased over time. Gestational age, sex, and race/ethnicity were independently associated with AUR (P < .01). AUR and gestational age had an unexpected inverse parabolic relationship, which persisted when only surviving infants without bacterial sepsis or necrotizing enterocolitis were analyzed.<br />Conclusions: Neonatal AURs are influenced by patient-level characteristics besides infection and survival status, including gestational age, sex, and race/ethnicity. Neonatal antibiotic use metrics that account for patient-level characteristics as well as morbidity case mix may allow for more accurate comparisons and better inform neonatal antibiotic stewardship efforts.<br /> (© The Author(s) 2020. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Subjects :
- Anti-Bacterial Agents therapeutic use
Humans
Infant
Infant, Newborn
Infant, Premature
Intensive Care Units, Neonatal
Retrospective Studies
United States epidemiology
Antimicrobial Stewardship
Enterocolitis, Necrotizing drug therapy
Enterocolitis, Necrotizing epidemiology
Infant, Premature, Diseases drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 2048-7207
- Volume :
- 10
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of the Pediatric Infectious Diseases Society
- Publication Type :
- Academic Journal
- Accession number :
- 32170951
- Full Text :
- https://doi.org/10.1093/jpids/piaa022