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Hospital pediatrics · 2022

National Healthcare Safety Network 2018 Baseline Neonatal Standardized Antimicrobial Administration Ratios.

СтатьяНазвание и аннотация: Перевод в очереди
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O'Leary Erin N, Edwards Jonathan R, Srinivasan Arjun, Neuhauser Melinda M, Soe Minn M, Webb Amy K, Edwards Erika M, Horbar Jeffrey D, Soll Roger F, Roberts Jessica, Hicks Lauri A, Wu Hsiu, Zayack Denise, Braun David, Cali Susan, Edwards William H, Flannery Dustin D, Fleming-Dutra Katherine E, Guzman-Cottrill Judith A, Kuzniewicz Michael, Lee Grace M, Newland Jason, Olson Jared, Puopolo Karen M, Rogers Stefanie P, Schulman Joseph, Septimus Edward, Pollock Daniel A

Аннотация

BACKGROUND: The microbiologic etiologies, clinical manifestations, and antimicrobial treatment of neonatal infections differ substantially from infections in adult and pediatric patient populations. In 2019, the Centers for Disease Control and Prevention developed neonatal-specific (Standardized Antimicrobial Administration Ratios SAARs), a set of risk-adjusted antimicrobial use metrics that hospitals participating in the National Healthcare Safety Network's (NHSN's) antimicrobial use surveillance can use in their antibiotic stewardship programs (ASPs).

METHODS: The Centers for Disease Control and Prevention, in collaboration with the Vermont Oxford Network, identified eligible patient care locations, defined SAAR agent categories, and implemented neonatal-specific NHSN Annual Hospital Survey questions to gather hospital-level data necessary for risk adjustment. SAAR predictive models were developed using 2018 data reported to NHSN from eligible neonatal units.

RESULTS: The 2018 baseline neonatal SAAR models were developed for 7 SAAR antimicrobial agent categories using data reported from 324 neonatal units in 304 unique hospitals. Final models were used to calculate predicted antimicrobial days, the SAAR denominator, for level II neonatal special care nurseries and level II/III, III, and IV NICUs.

CONCLUSIONS: NHSN's initial set of neonatal SAARs provides a way for hospital ASPs to assess whether antimicrobial agents in their facility are used at significantly higher or lower rates compared with a national baseline or whether an individual SAAR value is above or below a specific percentile on a given SAAR distribution, which can prompt investigations into prescribing practices and inform ASP interventions.

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