Short-course antibiotic therapy for pneumonia in the neonatal intensive care unit.

Objective: To determine the adherence and safety outcomes of a 5-day antibiotic course with a "time-out" for treatment of "blood culture-negative" pneumonia in the NICU.

Study Design: Prospective surveillance of all infants diagnosed with pneumonia at 7 NICUs from 8/2020-12/2021. Safety outcomes were defined a priori by re-initiation of antibiotic therapy within 14 days after discontinuation and overall and sepsis-related mortality.

Short-course empiric antibiotic therapy for possible early-onset sepsis in the NICU.

Objective: On 2/2019, the Neonatal Antimicrobial Stewardship Program at Nationwide Children's Hospital recommended reducing empirical antibiotic therapy for early-onset sepsis (EOS) from 48 to 24 hours with a TIME-OUT. We describe our experience with this guideline and assess its safety.

Methods: Retrospective review of newborns evaluated for possible EOS at 6 NICUs from 12/2018-7/2019.

Implementation of an electronic pharmacy scoring tool to prioritize clinical pharmacists' daily workflow at a pediatric institution.

Purpose: To describe the development and implementation of an electronic pharmacy scoring tool (PST) to prioritize patients requiring clinical pharmacy intervention and assist in workload management in a freestanding pediatric hospital using quality improvement methodology.

Summary: The department of pharmacy at Nationwide Children's Hospital developed a pediatric-specific PST within the electronic medical record to aid in patient prioritization and ensuring proficient daily workflow and qualifying workload for clinical pharmacists. The PST identifies patients for monitoring of high-risk medications, complex medication regimens, or abnormal laboratory values related to medication management.

Effects of prophylactic indomethacin on intraventricular hemorrhage and adverse outcomes in neonatal intensive care unit.

Objective: To identify the relationship between prophylactic indomethacin (PI) administration and incidence of intraventricular hemorrhage.

Study Design: A retrospective analysis of extremely premature infants <27 weeks gestational age born between January 2014 and September 2020.

Results: A total of 421 infants were included from three of Nationwide Children's Hospital delivery centers.

Safety and Efficacy of Nafcillin for Empiric Therapy of Late-Onset Sepsis in the NICU.

Background And Objective: In 2014 at Nationwide Children's Hospital, the Neonatal Antimicrobial Stewardship Program recommended nafcillin over vancomycin for empirical therapy of possible late-onset sepsis (LOS) in infants without a history of methicillin-resistant Staphylococcus aureus colonization or infection. We report our experience with this guideline and assess its safety.

Methods: We retrospectively reviewed all infants who received nafcillin or vancomycin for empirical treatment of possible LOS at 3 NICUs before (January 2013-May 2014) and after (January 2017-March 2019) implementation of a vancomycin reduction guideline.

Nephrotoxic medications and associated acute kidney injury in hospitalized neonates.

Objectives: Hospitalized neonates are often treated with nephrotoxic medications, a known risk factor for acute kidney injury (AKI). Nephrotoxic medications and AKI, especially in periviable neonates, could be detrimental to nephrogenesis. Our objectives were to evaluate the prevalence of neonatal treatment with nephrotoxic medications and its relationship with AKI in in the first 28 days of life, and to delineate the associated demographics and diagnoses.

Evidence-Based Guidelines for Acute Stabilization and Management of Neonates with Persistent Pulmonary Hypertension of the Newborn.

Persistent pulmonary hypertension of the newborn, or PPHN, represents a challenging condition associated with high morbidity and mortality. Management is complicated by complex pathophysiology and limited neonatal specific evidence-based literature, leading to a lack of universal contemporary clinical guidelines for the care of these patients. To address this need and to provide consistent high-quality clinical care for this challenging population in our neonatal intensive care unit, we sought to develop a comprehensive clinical guideline for the acute stabilization and management of neonates with PPHN.

Parenteral Nutrition in Moderately Preterm, Otherwise Healthy Neonates Is Not Associated With Improved Short-Term Growth Outcomes.

Background: Parenteral nutrition (PN) serves a crucial role in providing nutrition to extremely premature infants who are at high risk for malnutrition. However, little is known about the impact of PN on short-term growth outcomes in moderately preterm infants.

Methods: In this retrospective cohort analysis, patients were included in the study if they were born at ≥32 but <34 weeks gestational age and had no major comorbidities.

Evaluation of the Efficacy of Enoxaparin in the Neonatal Intensive Care Unit.

Objective: This article evaluates the efficacy of enoxaparin when targeting anti-factor Xa levels of 0.5 to 1 units per milliliter in the neonatal intensive care unit.

Study Design: This is a retrospective chart review of 45 neonates receiving enoxaparin for the treatment of venous thromboembolism.

Adjuvant haploidentical virus-specific T lymphocytes for treatment of disseminated adenovirus infection in a premature infant.

We report the first therapeutic infusion of haploidentical virus-specific T lymphocytes (VSTs) to treat maternally-transmitted, disseminated adenovirus infection in a premature infant. Infusion of maternal VSTs, isolated using interferon-gamma capture, associated with clinical improvement and viral clearance.

A quality improvement project to reduce length of stay for neonatal abstinence syndrome.

Background And Objective: Neonatal abstinence syndrome (NAS), a self-limiting condition, is associated with clinical symptoms that may require pharmacological intervention. Optimal treatment of NAS remains undetermined, but the hospital length of stay (LOS) for patients with NAS is partially dependent upon a standard treatment protocol used. Prolonged LOS for patients with NAS can lead to adverse patient harm, impaired maternal-infant attachment, and significant health care costs.