Some Neonatal Intensive Care Units May Be Overusing Antibiotics

Treatment of infection is a mainstay of neonatal intensive care. In a study of 52,061 infants in 127 neonatal intensive care units (NICUs), researchers found that antibiotic use varied from 2.4 percent to 97.1 percent of patient-days, with the median being 24.5 percent of patient days.

To explore this wide variation and the possibility of antibiotic overuse in neonates, authors of the study, "Neonatal Intensive Care Unit Antibiotic Use," appearing in the May 2015 issue of Pediatrics (published online April 20) measured NICU antibiotic prescribing practices and their relationship with proven infection and other factors connected to antibiotic exposure.

The authors reviewed results of septic workups – evaluations for possible infection – and found that NICUs reported similar burdens of infection, but antibiotic use nonetheless varied widely, leading the authors to conclude that some NICUs may be overusing antibiotics.

They suggest that organizations that track NICU performance add antibiotic use rate to their evaluation criteria, with a goal of identifying warranted ranges of antibiotic use rates for NICUs based on the level of care provided.

Editor's note: A related commentary, "Antibiotic Use in Neonatal Intensive Care," also appears in the May 2015 issue of Pediatrics.

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4/20/2015 12:00 AM