One of the initiatives took place at Philadelphia-based St. Christopher’s Hospital for Children, which in 2020 established guidelines on recommended antibiotic durations for four common conditions: rule-out sepsis, culture-negative sepsis, tracheitis and uncomplicated pneumonia. The therapy durations ranged from two to seven days.
The hospital also implemented educational sessions and required antibiotic necessity documentation in the EHR for its 39-bed NICU. Within one year, the antibiotic utilization rate at St. Christopher’s decreased by 50%, while the utilization rate for culture-negative sepsis declined by 64%.
Mount Sinai Kravis Children’s Hospital in New York City targeted culture-negative sepsis. The goal was to reduce the number of treatment courses by 30% and treatment duration by 25%. After implementing guidelines, case audits, weekly antibiotic stewardship rounds and biweekly reviews, the hospital’s NICU saw an 81% decrease in antibiotic days of therapy for culture-negative sepsis.
“While antibiotics are frequently necessary for premature newborns, who are highly vulnerable to bacterial infections and sepsis, excessive antibiotic use in NICUs has been associated with a range of harms,” according to the Center for Infectious Disease Research & Policy.
These harms include late-onset sepsis, increased risk of childhood allergies, necrotizing enterocolitis and developing resistant organisms.
Read more about the studies here.
