Antimicrobial stewardship intervention to reduce unnecessary antibiotic doses in neonates


      • Antimicrobial stewardship can be impacted by antibiotic duration orders.
      • Wording of antibiotic duration orders can impact the number of doses administered.
      • Neonates with doses beyond the anticipated duration was reduced from 50%-7.2%.
      The wording of the antibiotic duration orders for neonatal sepsis was changed as an antimicrobial stewardship initiative to reduce the administration of unnecessary antibiotic doses. The change in wording allowed the patient to stop receiving antibiotics after they received 48 hours of therapy if the health care team had not received notification of a positive culture. This initiative led to a decrease in the number of neonates that received extra unnecessary doses from 50% to 7.2%.

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        • Simonsen KA
        • Anderson-Berry AL
        • Delair SF
        • Davies HD
        Early-onset neonatal sepsis.
        Clin Microbiol Rev. 2014; 27: 21-47
        • Bhat R
        • Custodio H
        • McCurley C
        • et al.
        Reducing antibiotic utilization rate in preterm infants: a quality improvement initiative.
        J Perinatol. 2018; 38: 421-429
        • Mukhopadhyay S
        • Sengupta S
        • Puopolo KM
        Challenges and opportunities for antibiotic stewardship among preterm infants.
        Arch Dis Child Fetal Neonatal Ed. 2018; 0: F1-F6
        • Cantey JB
        • Wozniak PS
        • Pruszynski JE
        • Sanchez PJ
        Reducing unnecessary antibiotic use in the neonatal intensive care unit (SCOUT): a prospective interrupted time-series study.
        Lancet Infect Dis. 2016; 16: 1178-1184
        • Ting JY
        • Roberts A
        • Sherlock R
        • et al.
        Duration of initial empirical antibiotic therapy and outcomes in very low birth weight infants.
        Pediatrics. 2019; 143e20182286
        • Ting JY
        • Synnes A
        • Roberts A
        • et al.
        Association of antibiotic utilization and neurodevelopmental outcomes among extremely low gestational age neonates without proven sepsis or necrotizing enterocolitis.
        Am J Perinatol. 2018; 35: 972-978
        • Fjalstad JW
        • Esaiassen E
        • Juvet LK
        • van den Anker JN
        • Klingenberg C
        Antibiotic therapy in neonates and impact on gut microbiota and antibiotic resistance development: a systematic review.
        J Antimicrob Chemother. 2018; 73: 569-580
        • Walker SAN
        • Cormier M
        • Elligsen M
        • et al.
        Development, evaluation and validation of a screening tool for late onset bacteremia in neonates – a pilot study.
        BMC Pediatr. 2019; 19: 253
        • Larsson DGJ
        Antibiotics in the environment.
        Ups J Med Sci. 2014; 119: 108-112