Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-26T06:31:13.306Z Has data issue: false hasContentIssue false

Application of an antibiotic spectrum index in the neonatal intensive care unit

Published online by Cambridge University Press:  29 July 2019

Alexandra C. Lahart*
Affiliation:
Division of Newborn Medicine, Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri
Christopher C. McPherson
Affiliation:
Division of Newborn Medicine, Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri
Jeffrey S. Gerber
Affiliation:
Division of Infectious Diseases and The Center for Pediatric Clinical Effectiveness, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
Barbara B. Warner
Affiliation:
Division of Newborn Medicine, Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri
Brian R. Lee
Affiliation:
Health Services and Outcomes Research, Children’s Mercy Hospital, Kansas City, Missouri
Jason G. Newland
Affiliation:
Division of Infectious Diseases, Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri
*
Author for correspondence: Alexandra C. Lahart, Division of Newborn Medicine, Department of Pediatrics, Washington University School of Medicine, 1 Children’s Place, St Louis, MO 63110. Email: [email protected]

Abstract

Antimicrobial stewardship programs typically use days of therapy to assess antimicrobial use. However, this metric does not account for the antimicrobial spectrum of activity. We applied an antibiotic spectrum index to a population of very-low-birth-weight infants to assess its utility to evaluate the impact of antimicrobial stewardship interventions.

Type
Concise Communication
Copyright
© 2019 by The Society for Healthcare Epidemiology of America. All rights reserved. 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Society for Healthcare Epidemiology of America, Infectious Diseases Society of America, Pediatric Infectious Diseases Society. Policy statement on antimicrobial stewardship by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), and the Pediatric Infectious Diseases Society (PIDS). Infect Control Hosp Epidemiol 2012;33:322327.CrossRefGoogle Scholar
Madaras-Kelly, K, Jones, M, Remington, R, et al. Antimicrobial de-escalation of treatment for healthcare-associated pneumonia within the Veterans’ Healthcare Administration. J Antimicrob Chemother 2016;71:539546.CrossRefGoogle Scholar
Madaras-Kelly, K, Jones, M, Remington, R, et al. Description and validation of a spectrum score method to measure antimicrobial de-escalation in healthcare associated pneumonia from electronic medical records data. BMC Infect Dis 2015;15:197.CrossRefGoogle ScholarPubMed
Gerber, JS, Hersh, AL, Kronman, MP, et al. Development and application of an antibiotic spectrum index for benchmarking antibiotic selection patterns across hospitals. Infect Control Hosp Epidemiol 2017;38:993997.CrossRefGoogle ScholarPubMed
Flannery, DD, Ross, RK, Mukhopadhyay, S, et al. Temporal trends and center variation in early antibiotic use among premature infants. JAMA Netw Open 2018;1:e180164.CrossRefGoogle ScholarPubMed
Cotten, CM, Taylor, S, Stoll, B, et al. Prolonged duration of initial empirical antibiotic treatment is associated with increased rates of necrotizing enterocolitis and death for extremely low birth weight infants. Pediatrics 2009;123:5866.CrossRefGoogle ScholarPubMed
Kuppala, VS, Meinzen-Derr, J, Morrow, AL, et al. Prolonged initial empirical antibiotic treatment is associated with adverse outcomes in premature infants. J Pediatr 2011;159:720725.CrossRefGoogle ScholarPubMed
Barlam, TF, Cosgrove, SE, Abbo, LM, et al. Implementing an antibiotic stewardship program: guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clin Infect Dis 2016;62:e51e77.CrossRefGoogle Scholar
Stenehjem, E, Hersh, AL, Sheng, X, et al. Antibiotic use in small community hospitals. Clin Infect Dis 2016;63:12731280.CrossRefGoogle ScholarPubMed
Cotten, CM, McDonald, S, Stoll, B, et al. The association of third-generation cephalosporin use and invasive candidiasis in extremely low birth-weight infants. Pediatrics 2006;118:717722.CrossRefGoogle ScholarPubMed