Identifying Meaningful Metrics of Neonatal Antibiotic Use

项目摘要/摘要 在任何情况下过度使用抗生素都会加速抗生素耐药性的发展，这是全球 健康。优化抗生素使用是对抗耐药性的一种策略。抗菌药物的医院间比对 国家抗生素管理实施政策建议使用抗生素，但要求准确 测量这种用途的量度。新生儿重症监护病房(NICU)的新生儿死亡率很高 抗生素暴露的风险。这项药物流行病学研究的目的是提供一个安全的框架 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 对所有NICU的抗生素使用情况进行基准评估；(2)制定新生儿抗生素使用指标，以说明 抗生素活性谱；以及(3)确定抗生素使用指标和 新生儿结局。AIMS 1-3将使用来自Premier Health数据库的新生儿数据，AIMS 2和3将 还利用宾夕法尼亚大学患者级别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，促进适当使用抗生素，以减少疟疾的传播 耐药细菌。该提案只关注新生儿，这是AHRQ优先考虑的人群。这个 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做法，并最终 提高新生儿护理的安全性和质量。 这一职业发展奖旨在支持达斯汀·弗兰纳里博士的过渡，他是 在宾夕法尼亚大学和费城儿童医院的儿科，成为一家独立的 内科医生兼科学家，并实现了成为全国新生儿抗生素专家的长期职业目标 儿科健康服务研究的管理者和领导者。此外，这一奖项将允许他获得 成功竞争R01资助所需的培训、指导和研究经验 在这个领域的研究。 弗兰纳里博士将接受药物流行病学研究方面的高级培训和经验学习 方法、先进的生物统计技术以及卫生服务和政策。宾夕法尼亚大学 费城儿童医院为开展此类研究提供了一流的研究环境。这 该项目将由一个著名的指导团队指导，该团队有成功合作和 奖学金，包括新生儿学、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.