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Infect Control Hosp Epidemiol. 2016 Aug;37(8):924-30. doi: 10.1017/ice.2016.95. Epub 2016 May 4.

Media Stories on NICU Outbreaks Lead to an Increased Prescription Rate of Third-Line Antibiotics in the Community of Neonatal Care.

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1Department of Pediatrics,University of Lübeck,Lübeck,Germany.
2Department of Neonatology University of Tübingen,Tübingen,Germany.
3Department of Pediatrics at Saar University,Homburg,Germany.
4Department of Pediatrics,University of Aachen,Aachen,Germany.
5Department of Pediatrics,University of Bonn,Bonn,Germany.
6Children's Hospital Links der Weser,Bremen,Germany.
7Center for Pediatrics and Adolescent Medicine and Center for Chronic Immunodeficiency,University Medical Center,Freiburg,Germany.
8Department of Pediatrics,University of Halle,Halle,Germany.
9Department of Pediatrics,University of Marburg,Marburg,Germany.
10Department of Neonatology,Hanover Medical School,Hanover,Germany.
11Department of Pediatrics,University of Leipzig,Leipzig,Germany.
12Institute of Medical Biometry and Statistics,University of Lübeck,Lübeck,Germany.
15Division of Molecular and Clinical Infectious Diseases,University of Lübeck,Lübeck,Germany.


BACKGROUND Between 2010 and 2012, 3 outbreaks of nosocomial infections in German neonatal intensive care units (NICUs) attracted considerable public interest. Headlines on national television channels and in newspapers had important consequences for the involved institutions and a negative impact on the relationship between families and staff in many German NICUs. OBJECTIVE To determine whether NICU outbreaks reported in the media influenced provider behavior in the community of neonatal care and led to more third-line antibiotic prescribing. DESIGN Observational cohort study. METHODS To investigate secular trends, we evaluated data for very-low-birth-weight infants (VLBWIs, birth weight <1,500 g) enrolled in the German Neonatal Network (GNN) between 2009 and 2014 (N=10,253). For outbreak effects, we specifically analyzed data for VLBWIs discharged 6 months before (n=2,428) and 6 months after outbreaks (n=2,508). RESULTS The exposure of all VLBWIs to third-line antibiotics increased after outbreaks (19.4% before vs 22.5% after; P=.007). This trend particularly affected male infants (4.6% increase; P=.005) and infants with a birth weight between 1,000 and 1,499 g (3.5% increase; P=.001) In a logistic regression analysis, month of discharge as linear variable of time was associated with increased exposure to third-line antibiotics (odds ratio [OR], 1.01; 95% confidence interval [CI], 1.009-1.014; P<.001), and discharge within the 6-month period after outbreak reports independently contributed to this long-term trend (OR, 1.14; 95% CI, 1.017-1.270; P=.024). CONCLUSIONS Media reports directly affect medical practice, eg, overuse of third-line antibiotics. Future communication and management strategies must be based on objective dialogues between the scientific community and investigative journalists. Infect Control Hosp Epidemiol 2016;37:924-930.

[Indexed for MEDLINE]

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