1 búsqueda de la palabra clave 'Neonatal antimicrobial stewardship'

A global point prevalence survey of antimicrobial use in neonatal intensive care units: The no-more-antibiotics and resistance (NO-MAS-R) study    

Público ISBD Título : A global point prevalence survey of antimicrobial use in neonatal intensive care units: The no-more-antibiotics and resistance (NO-MAS-R) study Tipo de documento : documento electrónico Fecha de publicación : 2021 Títulos uniformes : eClinicalMedicine Idioma : Inglés (eng) Palabras clave : Global point prevalence study  Neonatal infection  Neonatal antimicrobial stewardship  Antibiotics  Antifungal Resumen : Background: Global assessment of antimicrobial agents prescribed to infants in the neonatal intensive care unit (NICU) may inform antimicrobial stewardship efforts. Methods: We conducted a one-day global point prevalence study of all antimicrobials provided to NICU infants. Demographic, clinical, and microbiologic data were obtained including NICU level, census, birth weight, gestational/chronologic age, diagnoses, antimicrobial therapy (reason for use; length of therapy), antimicrobial stewardship program (ASP), and 30-day in-hospital mortality. Findings: On July 1, 2019, 26% of infants (580/2,265; range, 0–100%; median gestational age, 33 weeks; median birth weight, 1800 g) in 84 NICUs (51, high-income; 33, low-to-middle income) from 29 countries (14, high-income; 15, low-to-middle income) in five continents received ≥1 antimicrobial agent (92%, antibacterial; 19%, antifungal; 4%, antiviral). The most common reasons for antibiotic therapy were “rule-out” sepsis (32%) and “culture-negative” sepsis (16%) with ampicillin (40%), gentamicin (35%), amikacin (19%), vancomycin (15%), and meropenem (9%) used most frequently. For definitive treatment of presumed/confirmed infection, vancomycin (26%), amikacin (20%), and meropenem (16%) were the most prescribed agents. Length of therapy for culture-positive and “culture-negative” infections was 12 days (median; IQR, 8–14) and 7 days (median; IQR, 5–10), respectively. Mortality was 6% (42%, infection-related). An NICU ASP was associated with lower rate of antibiotic utilization (p = 0·02). Interpretation: Global NICU antibiotic use was frequent and prolonged regardless of culture results. NICU-specific ASPs were associated with lower antibiotic utilization rates, suggesting the need for their implementation worldwide. Mención de responsabilidad : Pavel Prusakov, PharmD, Debra A. Goff, PharmD, Phillip S. Wozniak, BA, Azraa Cassim, BPharm, Catherine E.A. Scipion, MD, Soledad Urzua, MD, Andrea Ronchi, MD, Lingkong Zeng, MD, Oluwaseun Ladipo-Ajayi, MBChB, Noelia Aviles-Otero, MD, Chisom R. Udeigwe-Okeke, MBBS, Rimma Melamed, MD, Rita C. Silveira, MD,Cinzia Auriti, MD, Claudia Beltran-Arroyave, MD, Elena Zamora-Flores, MD, Maria Sanchez-Codez, MD, Eric S. Donkor, PhD, Satu Kekomaki, MD, Nicoletta Mainini, MD, Rosalba Vivas Trochez, MD, Jamalyn Casey, PharmD, Juan M. Graus, MD, Mallory Muller, PharmD, Sara Singh, MBBS, Yvette Loeffen, MD, María Eulalia Tamayo Perez, MD, Gloria Isabel Ferreyra, MD, Victoria Lima-Rogel, MD, Barbara Perrone, MD, Giannina Izquierdo, MD, María Cernada, MD, Sylvia Stoffella, PharmD, Sebastian Okwuchukwu Ekenze, MD, Concepcion de Alba-Romero, MD, Chryssoula Tzialla, MD, Jennifer T. Pham, PharmD, Kenichiro Hosoi, MD, Magdalena Cecilia Calero Consuegra, MD, Pasqua Betta, MD, O. Alvaro Hoyos, MD, Emmanuel Roi Referencia : EClinicalMedicine. 2021 Jan 29;32:100727. DOI (Digital Object Identifier) : 10.1016/j.eclinm.2021.100727 PMID : 33554094 Derechos de uso : CC BY-NC-ND En línea : https://linkinghub.elsevier.com/retrieve/pii/S2589537021000079 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5860 A global point prevalence survey of antimicrobial use in neonatal intensive care units: The no-more-antibiotics and resistance (NO-MAS-R) study [documento electrónico] . - 2021. Obra : eClinicalMedicine Idioma : Inglés (eng) Palabras clave : Global point prevalence study  Neonatal infection  Neonatal antimicrobial stewardship  Antibiotics  Antifungal Resumen : Background: Global assessment of antimicrobial agents prescribed to infants in the neonatal intensive care unit (NICU) may inform antimicrobial stewardship efforts. Methods: We conducted a one-day global point prevalence study of all antimicrobials provided to NICU infants. Demographic, clinical, and microbiologic data were obtained including NICU level, census, birth weight, gestational/chronologic age, diagnoses, antimicrobial therapy (reason for use; length of therapy), antimicrobial stewardship program (ASP), and 30-day in-hospital mortality. Findings: On July 1, 2019, 26% of infants (580/2,265; range, 0–100%; median gestational age, 33 weeks; median birth weight, 1800 g) in 84 NICUs (51, high-income; 33, low-to-middle income) from 29 countries (14, high-income; 15, low-to-middle income) in five continents received ≥1 antimicrobial agent (92%, antibacterial; 19%, antifungal; 4%, antiviral). The most common reasons for antibiotic therapy were “rule-out” sepsis (32%) and “culture-negative” sepsis (16%) with ampicillin (40%), gentamicin (35%), amikacin (19%), vancomycin (15%), and meropenem (9%) used most frequently. For definitive treatment of presumed/confirmed infection, vancomycin (26%), amikacin (20%), and meropenem (16%) were the most prescribed agents. Length of therapy for culture-positive and “culture-negative” infections was 12 days (median; IQR, 8–14) and 7 days (median; IQR, 5–10), respectively. Mortality was 6% (42%, infection-related). An NICU ASP was associated with lower rate of antibiotic utilization (p = 0·02). Interpretation: Global NICU antibiotic use was frequent and prolonged regardless of culture results. NICU-specific ASPs were associated with lower antibiotic utilization rates, suggesting the need for their implementation worldwide. Mención de responsabilidad : Pavel Prusakov, PharmD, Debra A. Goff, PharmD, Phillip S. Wozniak, BA, Azraa Cassim, BPharm, Catherine E.A. Scipion, MD, Soledad Urzua, MD, Andrea Ronchi, MD, Lingkong Zeng, MD, Oluwaseun Ladipo-Ajayi, MBChB, Noelia Aviles-Otero, MD, Chisom R. Udeigwe-Okeke, MBBS, Rimma Melamed, MD, Rita C. Silveira, MD,Cinzia Auriti, MD, Claudia Beltran-Arroyave, MD, Elena Zamora-Flores, MD, Maria Sanchez-Codez, MD, Eric S. Donkor, PhD, Satu Kekomaki, MD, Nicoletta Mainini, MD, Rosalba Vivas Trochez, MD, Jamalyn Casey, PharmD, Juan M. Graus, MD, Mallory Muller, PharmD, Sara Singh, MBBS, Yvette Loeffen, MD, María Eulalia Tamayo Perez, MD, Gloria Isabel Ferreyra, MD, Victoria Lima-Rogel, MD, Barbara Perrone, MD, Giannina Izquierdo, MD, María Cernada, MD, Sylvia Stoffella, PharmD, Sebastian Okwuchukwu Ekenze, MD, Concepcion de Alba-Romero, MD, Chryssoula Tzialla, MD, Jennifer T. Pham, PharmD, Kenichiro Hosoi, MD, Magdalena Cecilia Calero Consuegra, MD, Pasqua Betta, MD, O. Alvaro Hoyos, MD, Emmanuel Roi Referencia : EClinicalMedicine. 2021 Jan 29;32:100727. DOI (Digital Object Identifier) : 10.1016/j.eclinm.2021.100727 PMID : 33554094 Derechos de uso : CC BY-NC-ND En línea : https://linkinghub.elsevier.com/retrieve/pii/S2589537021000079 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5860

Reserva

Reservar este documento

Ejemplares(1)

Código de barras	Número de Ubicación	Tipo de medio	Ubicación	Sección	Estado
DD001798	AC-2021-110	Archivo digital	Producción Científica	Artículos científicos	Disponible

Documentos electrónicos

2021-110 Adobe Acrobat PDF