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Improved use of antibiotics following implementation of antimicrobial stewardship in a neonatal intensive care unit

Published online by Cambridge University Press:  11 November 2024

Arna Yr Karelsdottir Open the ORCID record for Arna Yr Karelsdottir [Opens in a new window] ,
Thorunn Oskarsdottir ,
Olof Eir Hoffritz Open the ORCID record for Olof Eir Hoffritz [Opens in a new window] ,
Thordur Thorkelsson ,
Asgeir Haraldsson Open the ORCID record for Asgeir Haraldsson [Opens in a new window]  and
Valtyr Thors Open the ORCID record for Valtyr Thors [Opens in a new window]
Arna Yr Karelsdottir
Affiliation:
Faculty of Medicine, University of Iceland, Reykjavík, Iceland
Thorunn Oskarsdottir
Affiliation:
Department of Pharmacy, Landspitali – University Hospital, Reykjavík, Iceland
Olof Eir Hoffritz
Affiliation:
Faculty of Pharmaceutical Sciences, University of Iceland, Reykjavík, Iceland
Thordur Thorkelsson
Affiliation:
Faculty of Medicine, University of Iceland, Reykjavík, Iceland Children’s Hospital Iceland, Landspitali – University Hospital, Reykjavík, Iceland
Asgeir Haraldsson
Affiliation:
Faculty of Medicine, University of Iceland, Reykjavík, Iceland Children’s Hospital Iceland, Landspitali – University Hospital, Reykjavík, Iceland
Valtyr Thors*
Affiliation:
Faculty of Medicine, University of Iceland, Reykjavík, Iceland Children’s Hospital Iceland, Landspitali – University Hospital, Reykjavík, Iceland
*
Corresponding author: Valtyr Thors; Email: [email protected]
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Abstract

Introduction:

Inappropriate antibiotic use in infants can have multiple adverse effects and contribute to the development of bacteria resistant to antimicrobials. Antimicrobial stewardship programs can reduce unnecessary antibiotic use in children. The aim of this study was to evaluate the effect of an antimicrobial stewardship program implemented in 2017 in the Neonatal Intensive Care Unit (NICU) at The Children’s Hospital Iceland.

Materials and methods:

The study included all infants who were admitted to the NICU during the study period (January 1st 2012–October 31st 2020). Data was collected from hospital records. Three periods were defined: preimplementation (2012–2014), peri-implementation (2015–2016) and postimplementation (2017–October 2020). Antibiotic use was quantified using days of therapy (DOT) per 1000 bed days (BD). For statistical analysis the pre- and postimplementation periods were compared.

Results:

Antibiotics were administered in 38.6% (1372) of admissions to the NICU during the study period. Antimicrobial use per year decreased from 584.6 to 317.1 DOT/1000 BD per year (P < 0.001). Use of broad-spectrum antibiotics decreased significantly. The average number of BD per month decreased from 297.8 to 220.9 BD/month (P = 0.0096). There were no significant changes in the length of stay for each infant or the proportion of readmissions or retreatment.

Conclusion:

Increased awareness of appropriate use of antimicrobials in the NICU led to shorter treatments and less use of broad-spectrum antibiotics. No increase in adverse effects such as readmissions or retreatment was observed.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 45 , Issue 12 , December 2024 , pp. 1448 - 1454
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Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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