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Infect Dis Clin North Am. 2014 Jun;28(2):247-61. doi: 10.1016/j.idc.2014.01.005.

Antimicrobial stewardship in the NICU.

Author information

1
Division of Pediatric Infectious Disease, Department of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA; Division of Neonatal/Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA. Electronic address: Joseph.Cantey@UTSouthwestern.edu.
2
Division of Pediatric Infectious Diseases, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago Northwestern University Feinberg School of Medicine, 225 East Chicago Avenue, Box 20, Chicago, Illinois 60611-2605, USA.

Abstract

There are unique challenges to antimicrobial stewardship in neonatal intensive care units (NICUs). Diagnosis of infection is difficult as neonates can have nonspecific signs and symptoms. Between and within NICUs, significant variation exists in the treatment duration of suspected sepsis and pneumonia. Development of multidisciplinary teams and meaningful metrics are essential for sustainable antibiotic stewardship. Potential stewardship interventions include optimizing culturing techniques, guiding empiric therapy by NICU-specific antibiograms, using ancillary laboratory tests, and promptly discontinuing therapy once infection is no longer suspected. Use of large neonatal databases can be used to benchmark antibiotic use and conduct comparative effectiveness research.

KEYWORDS:

Antimicrobial; Metrics; Neonatal intensive care unit; Stewardship

PMID:
24857391
DOI:
10.1016/j.idc.2014.01.005
[Indexed for MEDLINE]

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