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

Frontiers in Pediatrics

article

Catalina Morales-Betancourt¹  Javier De la Cruz-Bértolo²  Bárbara Muñoz-Amat¹  Elena Bergón-Sendín¹  Carmen Pallás-Alonso¹ 

[1] Department of Neonatology, 12 de Octubre University Hospital;Health Research Institute Imas 12, 12 de Octubre University Hospital;Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin ,(RICORS), Instituto de Salud Carlos III

关键词: quality improvement;    antibiotic stewardship;    neonatal intensive care;    very low birth weight;    process indicators;   

DOI  :  10.3389/fped.2022.913175

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

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.

【 授权许可】

CC BY