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Prescription of Aminoglycosides in 23 French Neonatal Intensive Care Units

Background: Aminoglycosides are the most prescribed antibiotics in neonatal intensive care units (NICU). Reducing exposure to antibiotics in the NICU is highly desirable, particularly through benchmarking methods. Methods: Description of aminoglycosides prescriptions in 23 French NICU using the same...

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Autores principales: Martin-Mons, Séverine, Gouyon, Béatrice, Lorrain, Séverine, Abasse, Soumeth, Alexandre, Cénéric, Binson, Guillaume, Brat, Roselyne, Caeymaex, Laurence, Couringa, Yvan, Desbruyeres, Cécile, Meglio, Marine Dorsi-Di, Escourrou, Guillaume, Flamein, Florence, Flechelles, Olivier, Girard, Olivier, Kermorvant-Duchemin, Elsa, Lapillonne, Alexandre, Lafon, Catherine, Di Maio, Massimo, Mazeiras, Gaël, Mourdie, Julien, Moussy-Durandy, Amélie, Pages, Anne-Sophie, Ramful, Duksha, Razafimahefa, Hasinirina, Rosenthal, Jean-Marc, Iacobelli, Silvia, Gouyon, Jean-Bernard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8614949/
https://www.ncbi.nlm.nih.gov/pubmed/34827360
http://dx.doi.org/10.3390/antibiotics10111422
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author Martin-Mons, Séverine
Gouyon, Béatrice
Lorrain, Séverine
Abasse, Soumeth
Alexandre, Cénéric
Binson, Guillaume
Brat, Roselyne
Caeymaex, Laurence
Couringa, Yvan
Desbruyeres, Cécile
Meglio, Marine Dorsi-Di
Escourrou, Guillaume
Flamein, Florence
Flechelles, Olivier
Girard, Olivier
Kermorvant-Duchemin, Elsa
Lapillonne, Alexandre
Lafon, Catherine
Di Maio, Massimo
Mazeiras, Gaël
Mourdie, Julien
Moussy-Durandy, Amélie
Pages, Anne-Sophie
Ramful, Duksha
Razafimahefa, Hasinirina
Rosenthal, Jean-Marc
Iacobelli, Silvia
Gouyon, Jean-Bernard
author_facet Martin-Mons, Séverine
Gouyon, Béatrice
Lorrain, Séverine
Abasse, Soumeth
Alexandre, Cénéric
Binson, Guillaume
Brat, Roselyne
Caeymaex, Laurence
Couringa, Yvan
Desbruyeres, Cécile
Meglio, Marine Dorsi-Di
Escourrou, Guillaume
Flamein, Florence
Flechelles, Olivier
Girard, Olivier
Kermorvant-Duchemin, Elsa
Lapillonne, Alexandre
Lafon, Catherine
Di Maio, Massimo
Mazeiras, Gaël
Mourdie, Julien
Moussy-Durandy, Amélie
Pages, Anne-Sophie
Ramful, Duksha
Razafimahefa, Hasinirina
Rosenthal, Jean-Marc
Iacobelli, Silvia
Gouyon, Jean-Bernard
author_sort Martin-Mons, Séverine
collection PubMed
description Background: Aminoglycosides are the most prescribed antibiotics in neonatal intensive care units (NICU). Reducing exposure to antibiotics in the NICU is highly desirable, particularly through benchmarking methods. Methods: Description of aminoglycosides prescriptions in 23 French NICU using the same computerized system over a 4-year period (2017–2020). A benchmarking program of antibiotics prescription was associated. Results: The population included 53,818 patients. Exposition rates to gentamicin and amikacin were 31.7% (n = 17,049) and 9.1% (n = 4894), respectively. Among neonates exposed to gentamicin, 90.4% of gentamicin and 77.6% of amikacin treatments were started within the 1st week of life. Among neonates exposed to amikacin, 77.6% started amikacin within the 1st week. The average daily dose of gentamicin at first prescription increased over the study period from 3.9 in 2017 to 4.4 mg/kg/d in 2020 (p < 0.0001). Conversely, the corresponding amikacin daily doses decreased from 13.0 in 2017 to 12.3 mg/kg/d in 2020 (p = 0.001). The time interval between the first 2 doses of gentamicin was mainly distributed in 3 values during the first week of life: 49.4% at 24 h, 26.4% at 36 h, and 22.9% at 48 h. At first amikacin prescription, the time interval was distributed in 4 categories: 48% at 24 h, 4.1% at 30 h, 8.5% at 36 h, and 37.1% at 48 h. As compared to literature guidelines, the rates of overdose and underdose in gentamicin (1.5% and 2.7%) and amikacin (0.3% and 1.0%). They significantly decreased for gentamicin over the study period. In multivariate analysis, the factors significantly associated with GENT overdose were the year of admission, prematurity, length of stay, and duration of the treatment. Conclusion: This prescription strategy ensured a low rate of overdose and underdose, and some benefits of the benchmarking program is suggested.
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spelling pubmed-86149492021-11-26 Prescription of Aminoglycosides in 23 French Neonatal Intensive Care Units Martin-Mons, Séverine Gouyon, Béatrice Lorrain, Séverine Abasse, Soumeth Alexandre, Cénéric Binson, Guillaume Brat, Roselyne Caeymaex, Laurence Couringa, Yvan Desbruyeres, Cécile Meglio, Marine Dorsi-Di Escourrou, Guillaume Flamein, Florence Flechelles, Olivier Girard, Olivier Kermorvant-Duchemin, Elsa Lapillonne, Alexandre Lafon, Catherine Di Maio, Massimo Mazeiras, Gaël Mourdie, Julien Moussy-Durandy, Amélie Pages, Anne-Sophie Ramful, Duksha Razafimahefa, Hasinirina Rosenthal, Jean-Marc Iacobelli, Silvia Gouyon, Jean-Bernard Antibiotics (Basel) Article Background: Aminoglycosides are the most prescribed antibiotics in neonatal intensive care units (NICU). Reducing exposure to antibiotics in the NICU is highly desirable, particularly through benchmarking methods. Methods: Description of aminoglycosides prescriptions in 23 French NICU using the same computerized system over a 4-year period (2017–2020). A benchmarking program of antibiotics prescription was associated. Results: The population included 53,818 patients. Exposition rates to gentamicin and amikacin were 31.7% (n = 17,049) and 9.1% (n = 4894), respectively. Among neonates exposed to gentamicin, 90.4% of gentamicin and 77.6% of amikacin treatments were started within the 1st week of life. Among neonates exposed to amikacin, 77.6% started amikacin within the 1st week. The average daily dose of gentamicin at first prescription increased over the study period from 3.9 in 2017 to 4.4 mg/kg/d in 2020 (p < 0.0001). Conversely, the corresponding amikacin daily doses decreased from 13.0 in 2017 to 12.3 mg/kg/d in 2020 (p = 0.001). The time interval between the first 2 doses of gentamicin was mainly distributed in 3 values during the first week of life: 49.4% at 24 h, 26.4% at 36 h, and 22.9% at 48 h. At first amikacin prescription, the time interval was distributed in 4 categories: 48% at 24 h, 4.1% at 30 h, 8.5% at 36 h, and 37.1% at 48 h. As compared to literature guidelines, the rates of overdose and underdose in gentamicin (1.5% and 2.7%) and amikacin (0.3% and 1.0%). They significantly decreased for gentamicin over the study period. In multivariate analysis, the factors significantly associated with GENT overdose were the year of admission, prematurity, length of stay, and duration of the treatment. Conclusion: This prescription strategy ensured a low rate of overdose and underdose, and some benefits of the benchmarking program is suggested. MDPI 2021-11-20 /pmc/articles/PMC8614949/ /pubmed/34827360 http://dx.doi.org/10.3390/antibiotics10111422 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Martin-Mons, Séverine
Gouyon, Béatrice
Lorrain, Séverine
Abasse, Soumeth
Alexandre, Cénéric
Binson, Guillaume
Brat, Roselyne
Caeymaex, Laurence
Couringa, Yvan
Desbruyeres, Cécile
Meglio, Marine Dorsi-Di
Escourrou, Guillaume
Flamein, Florence
Flechelles, Olivier
Girard, Olivier
Kermorvant-Duchemin, Elsa
Lapillonne, Alexandre
Lafon, Catherine
Di Maio, Massimo
Mazeiras, Gaël
Mourdie, Julien
Moussy-Durandy, Amélie
Pages, Anne-Sophie
Ramful, Duksha
Razafimahefa, Hasinirina
Rosenthal, Jean-Marc
Iacobelli, Silvia
Gouyon, Jean-Bernard
Prescription of Aminoglycosides in 23 French Neonatal Intensive Care Units
title Prescription of Aminoglycosides in 23 French Neonatal Intensive Care Units
title_full Prescription of Aminoglycosides in 23 French Neonatal Intensive Care Units
title_fullStr Prescription of Aminoglycosides in 23 French Neonatal Intensive Care Units
title_full_unstemmed Prescription of Aminoglycosides in 23 French Neonatal Intensive Care Units
title_short Prescription of Aminoglycosides in 23 French Neonatal Intensive Care Units
title_sort prescription of aminoglycosides in 23 french neonatal intensive care units
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8614949/
https://www.ncbi.nlm.nih.gov/pubmed/34827360
http://dx.doi.org/10.3390/antibiotics10111422
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