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Reducing Early Antibiotic Use: A Quality Improvement Initiative in a Level III Neonatal Intensive Care Unit

Antibiotic burden is a critical issue in neonatal intensive care units (NICU) and antibiotic use is considered a quality indicator of neonatal care. Our aim was to optimize antibiotic use through a quality improvement (QI) initiative that included revision of departmental protocols and implementatio...

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Autores principales: Morales-Betancourt, Catalina, De la Cruz-Bértolo, Javier, Muñoz-Amat, Bárbara, Bergón-Sendín, Elena, Pallás-Alonso, Carmen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9192948/
https://www.ncbi.nlm.nih.gov/pubmed/35712636
http://dx.doi.org/10.3389/fped.2022.913175
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author Morales-Betancourt, Catalina
De la Cruz-Bértolo, Javier
Muñoz-Amat, Bárbara
Bergón-Sendín, Elena
Pallás-Alonso, Carmen
author_facet Morales-Betancourt, Catalina
De la Cruz-Bértolo, Javier
Muñoz-Amat, Bárbara
Bergón-Sendín, Elena
Pallás-Alonso, Carmen
author_sort Morales-Betancourt, Catalina
collection PubMed
description Antibiotic burden is a critical issue in neonatal intensive care units (NICU) and antibiotic use is considered a quality indicator of neonatal care. Our aim was to optimize antibiotic use through a quality improvement (QI) initiative that included revision of departmental protocols and implementation of a surveillance system based on process indicators. METHODS: This is descriptive study of a cohort of all very low birth weight (VLBW) infants admitted to the NICU from 2014 to 2019. A series of QI interventions were made during the study period and included departmental protocols and the implementation of a surveillance system based on process indicators. The primary outcome was the percentage of VLBW infants who had received early antibiotics (ampicillin, gentamicin, or cefotaxime on the day of birth or day 1 or 2 after birth), antibiotics for longer than 3 days (despite negative blood culture), or no antibiotics. RESULTS: During the study period, a significant relative reduction was seen in the proportion of VLBW infants administered early antibiotics (46%; p < 0.01) and in infants provided antibiotics for longer than 3 days (90%; p < 0.01). Additionally, the percentage of VLBW with “no antibiotics” during their NICU stay increased fivefold (6 to 30%; p < 0.001). CONCLUSIONS: In our NICU, the implementation of a QI initiative that is based on affordable methods to track process indicators and evaluate the results led into a significant reduction in antibiotic exposure in VLBW infants. This approach is easy to implement in other NICUs as well.
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spelling pubmed-91929482022-06-15 Reducing Early Antibiotic Use: A Quality Improvement Initiative in a Level III Neonatal Intensive Care Unit Morales-Betancourt, Catalina De la Cruz-Bértolo, Javier Muñoz-Amat, Bárbara Bergón-Sendín, Elena Pallás-Alonso, Carmen Front Pediatr Pediatrics Antibiotic burden is a critical issue in neonatal intensive care units (NICU) and antibiotic use is considered a quality indicator of neonatal care. Our aim was to optimize antibiotic use through a quality improvement (QI) initiative that included revision of departmental protocols and implementation of a surveillance system based on process indicators. METHODS: This is descriptive study of a cohort of all very low birth weight (VLBW) infants admitted to the NICU from 2014 to 2019. A series of QI interventions were made during the study period and included departmental protocols and the implementation of a surveillance system based on process indicators. The primary outcome was the percentage of VLBW infants who had received early antibiotics (ampicillin, gentamicin, or cefotaxime on the day of birth or day 1 or 2 after birth), antibiotics for longer than 3 days (despite negative blood culture), or no antibiotics. RESULTS: During the study period, a significant relative reduction was seen in the proportion of VLBW infants administered early antibiotics (46%; p < 0.01) and in infants provided antibiotics for longer than 3 days (90%; p < 0.01). Additionally, the percentage of VLBW with “no antibiotics” during their NICU stay increased fivefold (6 to 30%; p < 0.001). CONCLUSIONS: In our NICU, the implementation of a QI initiative that is based on affordable methods to track process indicators and evaluate the results led into a significant reduction in antibiotic exposure in VLBW infants. This approach is easy to implement in other NICUs as well. Frontiers Media S.A. 2022-05-31 /pmc/articles/PMC9192948/ /pubmed/35712636 http://dx.doi.org/10.3389/fped.2022.913175 Text en Copyright © 2022 Morales-Betancourt, De la Cruz-Bértolo, Muñoz-Amat, Bergón-Sendín and Pallás-Alonso. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Morales-Betancourt, Catalina
De la Cruz-Bértolo, Javier
Muñoz-Amat, Bárbara
Bergón-Sendín, Elena
Pallás-Alonso, Carmen
Reducing Early Antibiotic Use: A Quality Improvement Initiative in a Level III Neonatal Intensive Care Unit
title Reducing Early Antibiotic Use: A Quality Improvement Initiative in a Level III Neonatal Intensive Care Unit
title_full Reducing Early Antibiotic Use: A Quality Improvement Initiative in a Level III Neonatal Intensive Care Unit
title_fullStr Reducing Early Antibiotic Use: A Quality Improvement Initiative in a Level III Neonatal Intensive Care Unit
title_full_unstemmed Reducing Early Antibiotic Use: A Quality Improvement Initiative in a Level III Neonatal Intensive Care Unit
title_short Reducing Early Antibiotic Use: A Quality Improvement Initiative in a Level III Neonatal Intensive Care Unit
title_sort reducing early antibiotic use: a quality improvement initiative in a level iii neonatal intensive care unit
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9192948/
https://www.ncbi.nlm.nih.gov/pubmed/35712636
http://dx.doi.org/10.3389/fped.2022.913175
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