Department of Neonatology, 12 de Octubre University Hospital, Avenida de Córdoba S/N, Madrid, 28041, Spain.
Escuela de Doctorado, Universidad de Alcalá, Ciencias de la salud, Madrid, Spain.
BMC Pediatr. 2024 Apr 5;24(1):245. doi: 10.1186/s12887-024-04637-x.
Antibiotic use for early-onset sepsis represents a high percentage of antibiotic consumption in the neonatal setting. Measures to assess infants at risk of early-onset sepsis are needed to optimize antibiotic use. Our primary objective was to assess the impact of a departmental guideline on antibiotic use among term infants with suspected EOS not confirmed, in our neonatal unit.
Retrospective cohort study, to compare antibiotic use in term infants during a baseline period of January to December 2018, and a postintervention period from October 2019, to September 2020, respectively. The primary outcome was antibiotic use measured by days of therapy, the antibiotic spectrum index, the antibiotic use rate, and the length of therapy.
We included 71 infants in the baseline period and 66 infants in the postintervention period. Compared to those in the baseline period, there was a significant reduction in overall antibiotic measures in the postintervention period, (P < 0.001). The total days of therapy/1000 patient-days decreased from 63/1000 patient-days during the baseline period to 25.8/1000 patient-days in the postintervention period, representing a relative reduction of 59%. The antibiotic use rate decreased by more than half of the infants, from 3.2% during the baseline period to 1.3% in the postintervention period.
The use of a departmental guideline to assess infants at risk of early-onset sepsis based on their clinical condition and prompt discontinuation of antibiotics, is a simple and low-cost measure that contributed to an important decrease in antibiotic use.
在新生儿环境中，用于早发性败血症的抗生素使用量占抗生素总消耗的很大比例。需要采取措施来评估有早发性败血症风险的婴儿，以优化抗生素的使用。我们的主要目标是评估部门指南对我们新生儿病房中疑似早发性败血症但未经证实的足月婴儿的抗生素使用的影响。
回顾性队列研究，分别比较 2018 年 1 月至 12 月的基线期和 2019 年 10 月至 2020 年 9 月的干预后期间，足月婴儿的抗生素使用情况。主要结果是通过治疗天数、抗生素谱指数、抗生素使用率和治疗时间来衡量抗生素的使用。
我们纳入了 71 名基线期婴儿和 66 名干预后婴儿。与基线期相比，干预后总体抗生素措施显著减少（P < 0.001）。治疗天数/1000 患者天数从基线期的 63/1000 患者天数降至干预后的 25.8/1000 患者天数，相对减少了 59%。抗生素使用率也降低了一半以上，从基线期的 3.2%降至干预后的 1.3%。
根据临床情况评估婴儿早发性败血症风险，并及时停止使用抗生素，使用部门指南是一种简单、低成本的措施，有助于大幅减少抗生素的使用。
