Antibiotic spectrum index: A new tool comparing antibiotic use in three NICUs.
Antibiotic spectrum index: A new tool comparing antibiotic use in three NICUs.
复制标题
DOI：
10.1017/ice.2021.467
复制
发表时间：
2022-11
影响因子：
4.5
通讯作者：
Vesoulis, Zachary A.
中科院分区：
文献类型：
--
作者：
Sullivan, Brynne A.;Panda, Aneesha;Wallman-Stokes, Aaron;Sahni, Rakesh;Fairchild, Karen D.;Newland, Jason G.;McPherson, Christopher C.;Vesoulis, Zachary A.
抗生素广泛用于极低出生体重（VLBW，<1500 g）婴儿，过量暴露，特别是广谱抗生素，与显著的发病率相关。抗生素谱指数（ASI）通过相对抗微生物活性量化抗生素暴露，将信息添加到通过治疗天数（DOT）测量的暴露中。我们比较了多个中心的ASI和DOT，以评估抗生素暴露的差异。我们从两个地点的三个IV级NICU收治的患者中提取了两年的数据，第三个地点的数据为一年。我们计算了所有入院的胎龄<32周的VLBW婴儿的每抗生素日ASI（AD）和每患者日DOT（PD）。临床变量以每1,000例PD的百分比或天数进行比较。我们使用Kruskal-Wallis检验比较三个研究中心的连续变量。纳入的734例VLBW婴儿的人口统计学特征相似。每PD DOT最高的部位每AD的ASI最低，死亡率和感染率最高的部位每AD的ASI最高。抗生素的使用因中心而异，特别是选择广谱覆盖，尽管引起感染的微生物是相似的。抗生素谱指数确定了三个NICU之间处方实践模式的差异，这些模式与标准抗生素使用指标所确定的模式不同。ASI反映了感染率和单位实践或抗生素处方指南的研究中心差异。该比较揭示了改善抗生素管理的机会，并证明了该指标在比较NICU人群抗生素暴露方面的实用性。
Antibiotics are widely used in very low birthweight (VLBW, <1500g) infants, and excess exposure, particularly to broad-spectrum antibiotics, is associated with significant morbidity. An antibiotic spectrum index (ASI) quantifies antibiotic exposure by relative antimicrobial activity, adding information to exposure measured by days of therapy (DOT). We compared ASI and DOT across multiple centers to evaluate differences in antibiotic exposures. We extracted data from patients admitted to three level-IV NICUs for two years at two sites and one year at the third site. We calculated the ASI per antibiotic days (AD) and DOT per patient-days (PD) for all admitted VLBW infants <32 weeks gestational age. Clinical variables were compared as percent or days per 1,000 PD. We used Kruskal-Wallis tests to compare continuous variables across the three sites. Demographics were similar for 734 VLBW infants included. The site with the highest DOT per PD had the lowest ASI per AD and the site with the highest mortality and infection rates had the highest ASI per AD. Antibiotic utilization varied by center, particularly for choice of broad-spectrum coverage, although the organisms causing infection were similar. An antibiotic spectrum index identified differences in prescribing practice patterns among three NICUs unique from those identified by standard antibiotic use metrics. Site differences in infection rates and unit practices or guidelines for prescribing antibiotics were reflected in the ASI. This comparison uncovered opportunities to improve antibiotic stewardship and demonstrated the utility of this metric for comparing antibiotic exposures among NICU populations.
登录
查看更多内容
DOI：
10.1080/14767058.2018.1481042
发表时间：
2019-12-17
影响因子：
1.8
作者：
Fajardo, Carlos;Alshaikh, Belal;Harabor, Andrei
通讯作者：
Harabor, Andrei
影响因子：
4.5
作者：
Lahart, Alexandra C.;McPherson, Christopher C.;Newland, Jason G.
通讯作者：
Newland, Jason G.
影响因子：
3.6
作者：
Dardas, Majd;Gill, Steven R.;Guillet, Ronnie
通讯作者：
Guillet, Ronnie
影响因子：
8
作者：
Rubin, LG;S치nchez, PJ;Jarvis, WR
通讯作者：
Jarvis, WR
影响因子：
11.8
作者：
van Santen, Katharina L.;Edwards, Jonathan R.;Pollock, Daniel A.
通讯作者：
Pollock, Daniel A.