Dataset Information

A global point prevalence survey of antimicrobial use in neonatal intensive care units: The no-more-antibiotics and resistance (NO-MAS-R) study.

ABSTRACT:

Background

Global assessment of antimicrobial agents prescribed to infants in the neonatal intensive care unit (NICU) may inform antimicrobial stewardship efforts.

Methods

We conducted a one-day global point prevalence study of all antimicrobials provided to NICU infants. Demographic, clinical, and microbiologic data were obtained including NICU level, census, birth weight, gestational/chronologic age, diagnoses, antimicrobial therapy (reason for use; length of therapy), antimicrobial stewardship program (ASP), and 30-day in-hospital mortality.

Findings

On July 1, 2019, 26% of infants (580/2,265; range, 0-100%; median gestational age, 33 weeks; median birth weight, 1800 g) in 84 NICUs (51, high-income; 33, low-to-middle income) from 29 countries (14, high-income; 15, low-to-middle income) in five continents received ?1 antimicrobial agent (92%, antibacterial; 19%, antifungal; 4%, antiviral). The most common reasons for antibiotic therapy were "rule-out" sepsis (32%) and "culture-negative" sepsis (16%) with ampicillin (40%), gentamicin (35%), amikacin (19%), vancomycin (15%), and meropenem (9%) used most frequently. For definitive treatment of presumed/confirmed infection, vancomycin (26%), amikacin (20%), and meropenem (16%) were the most prescribed agents. Length of therapy for culture-positive and "culture-negative" infections was 12 days (median; IQR, 8-14) and 7 days (median; IQR, 5-10), respectively. Mortality was 6% (42%, infection-related). An NICU ASP was associated with lower rate of antibiotic utilization (p = 0·02).

Interpretation

Global NICU antibiotic use was frequent and prolonged regardless of culture results. NICU-specific ASPs were associated with lower antibiotic utilization rates, suggesting the need for their implementation worldwide.

Funding

Merck & Co.; The Ohio State University College of Medicine Barnes Medical Student Research Scholarship.

SUBMITTER: Prusakov P

PROVIDER: S-EPMC7848759 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

A global point prevalence survey of antimicrobial use in neonatal intensive care units: The no-more-antibiotics and resistance (NO-MAS-R) study.

Prusakov Pavel P Goff Debra A DA Wozniak Phillip S PS Cassim Azraa A Scipion Catherine E A CEA Urzúa Soledad S Ronchi Andrea A Zeng Lingkong L Ladipo-Ajayi Oluwaseun O Aviles-Otero Noelia N Udeigwe-Okeke Chisom R CR Melamed Rimma R Silveira Rita C RC Auriti Cinzia C Beltrán-Arroyave Claudia C Zamora-Flores Elena E Sanchez-Codez Maria M Donkor Eric S ES Kekomäki Satu S Mainini Nicoletta N Trochez Rosalba Vivas RV Casey Jamalyn J Graus Juan M JM Muller Mallory M Singh Sara S Loeffen Yvette Y Pérez María Eulalia Tamayo MET Ferreyra Gloria Isabel GI Lima-Rogel Victoria V Perrone Barbara B Izquierdo Giannina G Cernada María M Stoffella Sylvia S Ekenze Sebastian Okwuchukwu SO de Alba-Romero Concepción C Tzialla Chryssoula C Pham Jennifer T JT Hosoi Kenichiro K Consuegra Magdalena Cecilia Calero MCC Betta Pasqua P Hoyos O Alvaro OA Roilides Emmanuel E Naranjo-Zuñiga Gabriela G Oshiro Makoto M Garay Victor V Mondì Vito V Mazzeo Danila D Stahl James A JA Cantey Joseph B JB Monsalve Juan Gonzalo Mesa JGM Normann Erik E Landgrave Lindsay C LC Mazouri Ali A Avila Claudia Alarcón CA Piersigilli Fiammetta F Trujillo Monica M Kolman Sonya S Delgado Verónica V Guzman Veronica V Abdellatif Mohamed M Monterrosa Luis L Tina Lucia Gabriella LG Yunis Khalid K Rodriguez Marco Antonio Belzu MAB Saux Nicole Le NL Leonardi Valentina V Porta Alessandro A Latorre Giuseppe G Nakanishi Hidehiko H Meir Michal M Manzoni Paolo P Norero Ximena X Hoyos Angela A Arias Diana D Sánchez Rubén García RG Medoro Alexandra K AK Sánchez Pablo J PJ

EClinicalMedicine 20210129

<h4>Background</h4>Global assessment of antimicrobial agents prescribed to infants in the neonatal intensive care unit (NICU) may inform antimicrobial stewardship efforts.<h4>Methods</h4>We conducted a one-day global point prevalence study of all antimicrobials provided to NICU infants. Demographic, clinical, and microbiologic data were obtained including NICU level, census, birth weight, gestational/chronologic age, diagnoses, antimicrobial therapy (reason for use; length of therapy), antimicro ...[more]

PMID: 33554094

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Dataset Information

A global point prevalence survey of antimicrobial use in neonatal intensive care units: The no-more-antibiotics and resistance (NO-MAS-R) study.

Background

Methods

Findings

Interpretation

Funding

Publications

A global point prevalence survey of antimicrobial use in neonatal intensive care units: The no-more-antibiotics and resistance (NO-MAS-R) study.

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