Unlabelled: Antibiotic burden is a critical issue in neonatal intensive care units (NICU) and antibiotic use is considered a quality indicator of neonatal care. Our aim was to optimize antibiotic use through a quality improvement (QI) initiative that included revision of departmental protocols and implementation of a surveillance system based on process indicators.
Methods: This is descriptive study of a cohort of all very low birth weight (VLBW) infants admitted to the NICU from 2014 to 2019. A series of QI interventions were made during the study period and included departmental protocols and the implementation of a surveillance system based on process indicators. The primary outcome was the percentage of VLBW infants who had received (ampicillin, gentamicin, or cefotaxime on the day of birth or day 1 or 2 after birth), (despite negative blood culture), or .
Results: During the study period, a significant relative reduction was seen in the proportion of VLBW infants administered early antibiotics (46%; < 0.01) and in infants provided antibiotics for longer than 3 days (90%; < 0.01). Additionally, the percentage of VLBW with "no antibiotics" during their NICU stay increased fivefold (6 to 30%; < 0.001).
Conclusions: In our NICU, the implementation of a QI initiative that is based on affordable methods to track process indicators and evaluate the results led into a significant reduction in antibiotic exposure in VLBW infants. This approach is easy to implement in other NICUs as well.
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| http://dx.doi.org/10.3389/fped.2022.913175 | DOI Listing |
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