Reducing Antibiotic Exposure in Suspected Neonatal Sepsis

Christopher Henry Grant; Andrew Arnott; Tim Brook; Alice Horne; William Hurst; Sarah Kelly; Christina Lang; Madeleine Payne; Hannah Pert; Sarah Sparrow; Pakaye Anne Dokubo; Natalie Bee; Ruth Gibbs; Julie-Clare Becher

doi:10.1177/0009922816689673

Reducing Antibiotic Exposure in Suspected Neonatal Sepsis

Christopher Henry Grant, Andrew Arnott, Tim Brook, Alice Horne, William Hurst, Sarah Kelly, Christina Lang, Madeleine Payne, Hannah Pert, Sarah Sparrow, Pakaye Anne Dokubo, Natalie Bee, Ruth Gibbs, Julie-Clare Becher (Lead / Corresponding author)

Population Health and Genomics

Research output: Contribution to journal › Article › peer-review

6 Citations (Scopus)

Abstract

Prolonged antibiotic therapy is associated with antimicrobial resistance and increased mortality in preterm infants. We evaluated the impact of an automatic stop order (ASO) and C-reactive protein (CRP) on the duration of antibiotics and level of intervention in infants screened for early-onset sepsis who had negative cultures. We introduced an ASO for low-risk infants, then, consequently, for all infants treated for suspected sepsis. We subsequently introduced a single CRP measurement at 36 hours. Between 2011 and 2014, 4 time periods were studied, at baseline and after each intervention. The proportion of infants receiving ≤48 hours of antibiotics increased from 19% to 72.5% (P <.0001), whereas that of infants receiving avoidable doses (>48 hours and <5 days) fell from 50% to 0.8% (P <.0001). The use of an ASO decreased the proportion receiving avoidable doses from 26/92 (28.3%) to 9/293 (3.1%); P <.0001. There was a reduction in lumbar punctures performed, from 35% to 20%; P =.015.

Original language	English
Pages (from-to)	76-81
Number of pages	6
Journal	Clinical Pediatrics
Volume	57
Issue number	1
DOIs	https://doi.org/10.1177/0009922816689673
Publication status	Published - 1 Jan 2018

Keywords

audit
intensive care
neonatology
pharmacology
therapeutics

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health

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10.1177/0009922816689673

Cite this

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title = "Reducing Antibiotic Exposure in Suspected Neonatal Sepsis",

abstract = "Prolonged antibiotic therapy is associated with antimicrobial resistance and increased mortality in preterm infants. We evaluated the impact of an automatic stop order (ASO) and C-reactive protein (CRP) on the duration of antibiotics and level of intervention in infants screened for early-onset sepsis who had negative cultures. We introduced an ASO for low-risk infants, then, consequently, for all infants treated for suspected sepsis. We subsequently introduced a single CRP measurement at 36 hours. Between 2011 and 2014, 4 time periods were studied, at baseline and after each intervention. The proportion of infants receiving ≤48 hours of antibiotics increased from 19% to 72.5% (P <.0001), whereas that of infants receiving avoidable doses (>48 hours and <5 days) fell from 50% to 0.8% (P <.0001). The use of an ASO decreased the proportion receiving avoidable doses from 26/92 (28.3%) to 9/293 (3.1%); P <.0001. There was a reduction in lumbar punctures performed, from 35% to 20%; P =.015.",

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author = "Grant, {Christopher Henry} and Andrew Arnott and Tim Brook and Alice Horne and William Hurst and Sarah Kelly and Christina Lang and Madeleine Payne and Hannah Pert and Sarah Sparrow and Dokubo, {Pakaye Anne} and Natalie Bee and Ruth Gibbs and Julie-Clare Becher",

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AU - Grant, Christopher Henry

AU - Arnott, Andrew

AU - Brook, Tim

AU - Horne, Alice

AU - Hurst, William

AU - Kelly, Sarah

AU - Lang, Christina

AU - Payne, Madeleine

AU - Pert, Hannah

AU - Sparrow, Sarah

AU - Dokubo, Pakaye Anne

AU - Bee, Natalie

AU - Gibbs, Ruth

AU - Becher, Julie-Clare

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Prolonged antibiotic therapy is associated with antimicrobial resistance and increased mortality in preterm infants. We evaluated the impact of an automatic stop order (ASO) and C-reactive protein (CRP) on the duration of antibiotics and level of intervention in infants screened for early-onset sepsis who had negative cultures. We introduced an ASO for low-risk infants, then, consequently, for all infants treated for suspected sepsis. We subsequently introduced a single CRP measurement at 36 hours. Between 2011 and 2014, 4 time periods were studied, at baseline and after each intervention. The proportion of infants receiving ≤48 hours of antibiotics increased from 19% to 72.5% (P <.0001), whereas that of infants receiving avoidable doses (>48 hours and <5 days) fell from 50% to 0.8% (P <.0001). The use of an ASO decreased the proportion receiving avoidable doses from 26/92 (28.3%) to 9/293 (3.1%); P <.0001. There was a reduction in lumbar punctures performed, from 35% to 20%; P =.015.

AB - Prolonged antibiotic therapy is associated with antimicrobial resistance and increased mortality in preterm infants. We evaluated the impact of an automatic stop order (ASO) and C-reactive protein (CRP) on the duration of antibiotics and level of intervention in infants screened for early-onset sepsis who had negative cultures. We introduced an ASO for low-risk infants, then, consequently, for all infants treated for suspected sepsis. We subsequently introduced a single CRP measurement at 36 hours. Between 2011 and 2014, 4 time periods were studied, at baseline and after each intervention. The proportion of infants receiving ≤48 hours of antibiotics increased from 19% to 72.5% (P <.0001), whereas that of infants receiving avoidable doses (>48 hours and <5 days) fell from 50% to 0.8% (P <.0001). The use of an ASO decreased the proportion receiving avoidable doses from 26/92 (28.3%) to 9/293 (3.1%); P <.0001. There was a reduction in lumbar punctures performed, from 35% to 20%; P =.015.

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Reducing Antibiotic Exposure in Suspected Neonatal Sepsis

Abstract

Keywords

ASJC Scopus subject areas

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