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Media Stories on NICU Outbreaks Lead to an Increased Prescription Rate of Third-Line Antibiotics in the Community of Neonatal Care

Published online by Cambridge University Press:  04 May 2016

Christoph Härtel ,
Annika Hartz ,
Lina Bahr ,
Christian Gille ,
Ludwig Gortner ,
Arne Simon ,
Thorsten Orlikowsky ,
Andreas Müller ,
Thorsten Körner  and
Philipp Henneke
...Show all authors
Christoph Härtel*
Affiliation:
Department of Pediatrics, University of Lübeck, Lübeck, Germany
Annika Hartz
Affiliation:
Department of Pediatrics, University of Lübeck, Lübeck, Germany
Lina Bahr
Affiliation:
Department of Pediatrics, University of Lübeck, Lübeck, Germany
Christian Gille
Affiliation:
Department of Neonatology University of Tübingen, Tübingen, Germany
Ludwig Gortner
Affiliation:
Department of Pediatrics at Saar University, Homburg, Germany
Arne Simon
Affiliation:
Department of Pediatrics at Saar University, Homburg, Germany
Thorsten Orlikowsky
Affiliation:
Department of Pediatrics, University of Aachen, Aachen, Germany
Andreas Müller
Affiliation:
Department of Pediatrics, University of Bonn, Bonn, Germany
Thorsten Körner
Affiliation:
Children’s Hospital Links der Weser, Bremen, Germany
Philipp Henneke
Affiliation:
Center for Pediatrics and Adolescent Medicine and Center for Chronic Immunodeficiency, University Medical Center, Freiburg, Germany
Roland Haase
Affiliation:
Department of Pediatrics, University of Halle, Halle, Germany
Michael Zemlin
Affiliation:
Department of Pediatrics, University of Marburg, Marburg, Germany
Dorothee Viemann
Affiliation:
Department of Neonatology, Hanover Medical School, Hanover, Germany
Corinna Gebauer
Affiliation:
Department of Pediatrics, University of Leipzig, Leipzig, Germany
Ulrich Thome
Affiliation:
Department of Pediatrics, University of Leipzig, Leipzig, Germany
Andreas Ziegler
Affiliation:
Institute of Medical Biometry and Statistics, University of Lübeck, Lübeck, Germany Center for Clinical Trials, University of Lübeck, Lübeck, Germany School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Pietermaritzburg, South Africa
Jan Rupp
Affiliation:
Division of Molecular and Clinical Infectious Diseases, University of Lübeck, Lübeck, Germany
Egbert Herting
Affiliation:
Department of Pediatrics, University of Lübeck, Lübeck, Germany
Wolfgang Göpel
Affiliation:
Department of Pediatrics, University of Lübeck, Lübeck, Germany
*
Address correspondence to Christoph Härtel, Department of Paediatrics, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany ([email protected]).
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Abstract

BACKGROUND

Between 2010 and 2012, 3 outbreaks of nosocomial infections in German neonatal intensive care units (NICUs) attracted considerable public interest. Headlines on national television channels and in newspapers had important consequences for the involved institutions and a negative impact on the relationship between families and staff in many German NICUs.

OBJECTIVE

To determine whether NICU outbreaks reported in the media influenced provider behavior in the community of neonatal care and led to more third-line antibiotic prescribing.

DESIGN

Observational cohort study.

METHODS

To investigate secular trends, we evaluated data for very-low-birth-weight infants (VLBWIs, birth weight <1,500 g) enrolled in the German Neonatal Network (GNN) between 2009 and 2014 (N=10,253). For outbreak effects, we specifically analyzed data for VLBWIs discharged 6 months before (n=2,428) and 6 months after outbreaks (n=2,508).

RESULTS

The exposure of all VLBWIs to third-line antibiotics increased after outbreaks (19.4% before vs 22.5% after; P=.007). This trend particularly affected male infants (4.6% increase; P=.005) and infants with a birth weight between 1,000 and 1,499 g (3.5% increase; P=.001)

In a logistic regression analysis, month of discharge as linear variable of time was associated with increased exposure to third-line antibiotics (odds ratio [OR], 1.01; 95% confidence interval [CI], 1.009–1.014; P<.001), and discharge within the 6-month period after outbreak reports independently contributed to this long-term trend (OR, 1.14; 95% CI, 1.017–1.270; P=.024).

CONCLUSIONS

Media reports directly affect medical practice, eg, overuse of third-line antibiotics. Future communication and management strategies must be based on objective dialogues between the scientific community and investigative journalists.

Infect Control Hosp Epidemiol 2016;37:924–930

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 37 , Issue 8 , August 2016 , pp. 924 - 930
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

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