A Blueprint for Targeted Antimicrobial Stewardship in Neonatal Intensive Care Units

Currently, there are guidelines for EOS evaluations and initiation of antibiotic therapy.9 However, there is much concern in the neonatology community that strict adherence to these guidelines will result in otherwise well-appearing infants with sterile blood cultures but with other lab abnormalitie...

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Bibliographic Details
Published in:Infection control and hospital epidemiology 2017-10, Vol.38 (10), p.1144-1146
Main Authors: Johnson, Candace L, Saiman, Lisa
Format: Article
Language:English
Subjects:
Ambulatory care
Anti-Bacterial Agents
Antibiotics
Antimicrobial Stewardship
Child
Clinical practice guidelines
Disease prevention
Drug resistance
Feedback
Hospitals
Humans
Infant, Newborn
Infants
Infections
Intensive care
Intensive Care Units
Intensive Care Units, Neonatal
Microbial Sensitivity Tests
Neonates
Newborn babies
Nursing
Nursing homes
Pathogens
Penicillin
Sepsis
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Summary:Currently, there are guidelines for EOS evaluations and initiation of antibiotic therapy.9 However, there is much concern in the neonatology community that strict adherence to these guidelines will result in otherwise well-appearing infants with sterile blood cultures but with other lab abnormalities (eg, elevated C-reactive protein or immature to total neutrophil ratio) being unnecessarily treated for ≥7 days for EOS.10 Given the growing evidence that the use of even ampicillin and gentamicin may adversely impact a neonate’s future health,6 a more accurate way to identify infants truly at risk for EOS is urgently needed. [...]the optimal outcome metric(s) for antimicrobial stewardship in the NICU is unknown. [...]optimizing antibiotic use in the NICU is challenging given the vulnerability of neonates to infection but necessary given the adverse effects of antibiotic misuse.
ISSN:0899-823X
1559-6834
DOI:10.1017/ice.2017.183