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A global point prevalence survey of antimicrobial use in neonatal intensive care units: The no-more-antibiotics and resistance (NO-MAS-R) study
Authors
M. Abdellatif
m.d Alessandro Porta
+79 more
D. Arias
C. Auriti
C.A. Avila
N. Aviles-Otero
C. Beltrán-Arroyave
P. Betta
J.B. Cantey
J. Casey
A. Cassim
M. Cernada
M.C.C. Consuegra
C. de Alba-Romero
V. Delgado
E.S. Donkor
S.O. Ekenze
G.I. Ferreyra
for the Global NEO-ASP Study Group,
V. Garay
m.d Giuseppe Latorre
D.A. Goff
J.M. Graus
V. Guzman
K. Hosoi
A. Hoyos
O.A. Hoyos
G. Izquierdo
S. Kekomäki
S. Kolman
O. Ladipo-Ajayi
L.C. Landgrave
G. Latorre
V. Leonardi
V. Lima-Rogel
Y. Loeffen
N. Mainini
P. Manzoni
A. Mazouri
D. Mazzeo
A.K. Medoro
M. Meir
R. Melamed
V. Mondì
J.G.M. Monsalve
L. Monterrosa
M. Muller
H. Nakanishi
G. Naranjo-Zuñiga
X. Norero
E. Normann
M. Oshiro
B. Perrone
J.T. Pham
F. Piersigilli
A. Porta
P. Prusakov
M.E.T. Pérez
M.A.B. Rodriguez
E. Roilides
A. Ronchi
M. Sanchez-Codez
N.L. Saux
C.E.A. Scipion
R.C. Silveira
S. Singh
J.A. Stahl
S. Stoffella
P.J. Sánchez
R.G. Sánchez
L.G. Tina
R.V. Trochez
M. Trujillo
C. Tzialla
C.R. Udeigwe-Okeke
S. Urzúa
m.d Valentina Leonardi
P.S. Wozniak
K. Yunis
E. Zamora-Flores
L. Zeng
Publication date
1 January 2021
Publisher
Doi
Cite
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 © 2021 The Author
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eprints Iran University of Medical Sciences
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oai:eprints.iums.ac.ir:33021
Last time updated on 15/04/2021
University of Illinois at Chicago: UIC INDIGO (INtellectual property in DIGital form available online in an Open environment)
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oai:figshare.com:article/14481...
Last time updated on 17/01/2024