Am J Perinatol. 2023 Aug 22. doi: 10.1055/a-2158-8422. Online ahead of print.
ABSTRACT
OBJECTIVE: In view of the excessive use of antibiotics in our Neonatal Intensive Care Unit(NICU), we launched a 5 year multidisciplinary quality improvement (QI)initiative in our NICU in 2018. We had set our AIM of decreasing the Antibiotic Use Rate (AUR) from 22% down to 17%.
STUDY DESIGN: The QI initiative was conducted in our 53-bed level 3B NICU. We used the core elements of antibiotic stewardship and focused on improving gaps in knowledge by using updated standards of care and a multidisciplinary approach. Outcome measures included overall antibiotic use rate in NICU. Statistical control chart (P chart) was used to plot the AUR data quarterly.
RESULTS: The AUR demonstrated a decline at the onset , and at the end of the initiative the AUR demonstrated a sustained decline to 13.18 % , a 40% decrease from the baseline AUR of 22%. The changes that were implemented included development of evidence-based guidelines for babies less than and greater than 35 weeks, daily Antibiotic Stewardship Rounds, sepsis risk calculator, antibiotic stop orders (48 hour stop, 36 hour soft stop and 36 hour hard stop) and periodic reviews.
CONCLUSIONS: Our multidisciplinary approach using all the core elements of an Antibiotic Stewardship Program (ASP) significantly decreased AUR in our NICU.
PMID:37607590 | DOI:10.1055/a-2158-8422
