Identifying Meaningful Metrics of Neonatal Antibiotic Use

项目总结/摘要 在所有环境中过度使用抗生素加速了抗生素耐药性的发展，这是全球环境的首要威胁。 健康优化抗生素使用是对抗耐药性的一种策略。医院间抗生素比较 国家抗生素管理实施政策建议使用，但需要准确的 测量这种使用。新生儿重症监护室（NICU）的新生儿 抗生素暴露。这项药物流行病学研究的目的是提供一个框架， 优化新生儿抗生素使用。该项目的具体目标是：（1）开发一种风险调整方法， NICU抗生素使用基准;（2）制定新生儿抗生素使用指标， 抗生素活性谱;以及（3）确定抗生素使用指标与 新生儿结局目标1-3将利用总理健康数据库的新生儿数据，目标2和3将 还利用宾夕法尼亚大学患者水平的新生儿数据进行验证。这项研究将直接解决 AHRQ的首要研究重点，促进适当的抗生素使用，以减少疾病的传播。 耐药细菌该提案专门侧重于新生儿，这是澳大利亚人权问题咨询机构的一个优先群体。的 这项研究的结果将确定新生儿抗生素使用的有意义的指标，以便医院和 利益相关者确定应该效仿或避免的抗生素使用实践， 提高新生儿护理的安全性和质量。 该职业发展奖旨在支持Dustin Flannery博士的过渡，他是一名 儿科在宾夕法尼亚大学和费城儿童医院，成为一个独立的 医生科学家，并实现他的长期职业目标，成为全国新生儿抗生素专家 儿科健康服务研究的管理和领导者。此外，该奖项将使他获得 成功竞争R 01赠款所需的培训、指导和研究经验 在这个竞技场的研究。 博士Flannery将接受药物流行病学研究方面的高级培训和体验式学习 方法，先进的生物统计技术，卫生服务和政策。宾夕法尼亚大学 和费城儿童医院提供了一个恒星的研究环境进行这样的研究。这 项目将由一个著名的指导团队与成功的合作记录， 奖学金，包括生殖病学、传染病、药物流行病学、卫生服务、 生物统计学和结果研究。

PROJECT SUMMARY/ABSTRACT Overuse of antibiotics in all settings accelerates the development of antibiotic resistance, a top threat to global health. Optimizing antibiotic use is a strategy for combatting resistance. Inter-hospital comparison of antibiotic use is recommended by national antibiotic stewardship implementation policies but requires accurate measurement of such use. Newborn infants admitted to neonatal intensive care units (NICUs) have high rates of antibiotic exposure. The purpose of this pharmacoepidemiology study is to provide a framework for safely optimizing neonatal antibiotic use. The project’s specific aims are (1) to develop a risk-adjusted method for benchmarking antibiotic use across NICUs; (2) to develop a neonatal antibiotic use metric that accounts for antibiotic spectrum of activity; and (3) to determine the associations between antibiotic use metrics and neonatal outcomes. Aims 1-3 will utilize neonatal data from the Premier Health Database and Aims 2 and 3 will also utilize University of Pennsylvania patient-level neonatal data for validation. This study will directly address a top AHRQ research priority, promoting appropriate antibiotic use in order to reduce the transmission of resistant bacteria. The proposal focuses exclusively on newborn infants, an AHRQ priority population. The results of this research will identify meaningful metrics of neonatal antibiotic use in order to allow hospitals and stakeholders to pinpoint antibiotic utilization practices that should be emulated or avoided, and ultimately improve the safety and quality of neonatal care. This career development award is designed to support the transition of Dr. Dustin Flannery, an Instructor of Pediatrics at the University of Pennsylvania and Children’s Hospital of Philadelphia, into an independent physician-scientist and to achieve his long-term career goal of becoming a national expert in neonatal antibiotic stewardship and leader in pediatric health services research. In addition, this award will allow him to obtain the training, mentorship, and research experience necessary to successfully compete for R01 grants supporting studies in this arena. Dr. Flannery will receive advanced training and experiential learning in pharmacoepidemiology research methods, advanced biostatistical techniques, and health services and policy. The University of Pennsylvania and Children’s Hospital of Philadelphia provide a stellar research environment to conduct such research. This project will be guided by a renowned mentorship team with a track record of successful collaboration and scholarship, including experts in neonatology, infectious diseases, pharmacoepidemiology, health services, biostatistics, and outcomes research.