MedElevator Войти в исследования
← Поиск публикаций

DOI 10.1016/j.eclinm.2021.100727

Медицинская библиотека · EClinicalMedicine · 2021

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

Prusakov Pavel, Goff Debra A, Wozniak Phillip S, Cassim Azraa, Scipion Catherine E A, Urzúa Soledad, Ronchi Andrea, Zeng Lingkong, Ladipo-Ajayi Oluwaseun, Aviles-Otero Noelia, Udeigwe-Okeke Chisom R, Melamed Rimma, Silveira Rita C, Auriti Cinzia, Beltrán-Arroyave Claudia, Zamora-Flores Elena, Sanchez-Codez Maria, Donkor Eric S, Kekomäki Satu, Mainini Nicoletta, Trochez Rosalba Vivas, Casey Jamalyn, Graus Juan M, Muller Mallory, Singh Sara, Loeffen Yvette, Pérez María Eulalia Tamayo, Ferreyra Gloria Isabel, Lima-Rogel Victoria, Perrone Barbara, Izquierdo Giannina, Cernada María, Stoffella Sylvia, Ekenze Sebastian Okwuchukwu, de Alba-Romero Concepción, Tzialla Chryssoula, Pham Jennifer T, Hosoi Kenichiro, Consuegra Magdalena Cecilia Calero, Betta Pasqua, Hoyos O Alvaro, Roilides Emmanuel, Naranjo-Zuñiga Gabriela, Oshiro Makoto, Garay Victor, Mondì Vito, Mazzeo Danila, Stahl James A, Cantey Joseph B, Monsalve Juan Gonzalo Mesa, Normann Erik, Landgrave Lindsay C, Mazouri Ali, Avila Claudia Alarcón, Piersigilli Fiammetta, Trujillo Monica, Kolman Sonya, Delgado Verónica, Guzman Veronica, Abdellatif Mohamed, Monterrosa Luis, Tina Lucia Gabriella, Yunis Khalid, Rodriguez Marco Antonio Belzu, Saux Nicole Le, Leonardi Valentina, Porta Alessandro, Latorre Giuseppe, Nakanishi Hidehiko, Meir Michal, Manzoni Paolo, Norero Ximena, Hoyos Angela, Arias Diana, Sánchez Rubén García, Medoro Alexandra K, Sánchez Pablo J, Global NEO-ASP Study Group

СтатьяПеревод в очереди

Аннотация

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.

FUNDING: Merck & Co.; The Ohio State University College of Medicine Barnes Medical Student Research Scholarship.

Для цитирования: Prusakov Pavel, Goff Debra A, Wozniak Phillip S, Cassim Azraa, Scipion Catherine E A, Urzúa Soledad, Ronchi Andrea, Zeng Lingkong, Ladipo-Ajayi Oluwaseun, Aviles-Otero Noelia, Udeigwe-Okeke Chisom R, Melamed Rimma, Silveira Rita C, Auriti Cinzia, Beltrán-Arroyave Claudia, Zamora-Flores Elena, Sanchez-Codez Maria, Donkor Eric S, Kekomäki Satu, Mainini Nicoletta, Trochez Rosalba Vivas, Casey Jamalyn, Graus Juan M, Muller Mallory, Singh Sara, Loeffen Yvette, Pérez María Eulalia Tamayo, Ferreyra Gloria Isabel, Lima-Rogel Victoria, Perrone Barbara, Izquierdo Giannina, Cernada María, Stoffella Sylvia, Ekenze Sebastian Okwuchukwu, de Alba-Romero Concepción, Tzialla Chryssoula, Pham Jennifer T, Hosoi Kenichiro, Consuegra Magdalena Cecilia Calero, Betta Pasqua, Hoyos O Alvaro, Roilides Emmanuel, Naranjo-Zuñiga Gabriela, Oshiro Makoto, Garay Victor, Mondì Vito, Mazzeo Danila, Stahl James A, Cantey Joseph B, Monsalve Juan Gonzalo Mesa, Normann Erik, Landgrave Lindsay C, Mazouri Ali, Avila Claudia Alarcón, Piersigilli Fiammetta, Trujillo Monica, Kolman Sonya, Delgado Verónica, Guzman Veronica, Abdellatif Mohamed, Monterrosa Luis, Tina Lucia Gabriella, Yunis Khalid, Rodriguez Marco Antonio Belzu, Saux Nicole Le, Leonardi Valentina, Porta Alessandro, Latorre Giuseppe, Nakanishi Hidehiko, Meir Michal, Manzoni Paolo, Norero Ximena, Hoyos Angela, Arias Diana, Sánchez Rubén García, Medoro Alexandra K, Sánchez Pablo J, Global NEO-ASP Study Group. A global point prevalence survey of antimicrobial use in neonatal intensive care units: The no-more-antibiotics and resistance (NO-MAS-R) study.. EClinicalMedicine. 2021. DOI: 10.1016/j.eclinm.2021.100727.
Подготовка и перевод публикации
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…

История · было → стало

Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.

Тип публикации указан по данным источника. Уровень доказательности автоматически не присваивается.