Background: Early exposure to antibiotic therapy has been linked to increased susceptibility to infection, obesity and asthma. The Stony Brook Neonatal Antibiotic Stewardship Program was initiated in 2015 to optimize antibiotic utility and minimize existing practice variations. Our unit's Antibiotic utilization rate (AUR) has consistently declined since Jan 2015.
Objective: Our objective was to decrease our antibiotic utilization rates (AUR) by 10% from January 2018 to December 2019 in patients at risk for early-onset sepsis (EOS).
Design/Methods: New antibiotic stewardship guidelines were initiated at our unit in January 2019 which included eliminating the 4th dose of Ampicillin when given as q12h dosing in patients at risk for EOS if their 24 hr CRP was <0.1 or Kaiser Sepsis Score <0.6. Data was analyzed retrospectively on all term and late preterm infants at risk for EOS admitted to NICU from January 2019-December 2019 following implementation of new guidelines (n=674, 57% due to maternal chorioamnionitis). Outcomes were compared to the same infant group prior to implementation from January 2018-December 2018 (n=738, 63% due to maternal chorioamnionitis).
Results: AUR decreased by 12%. The duration of antibiotic treatment for culture negative EOS trended lower with 20% decrease.
Conclusion: Instituting daily antibiotic stewardship rounds and monitoring adherence to steward guidelines can result in decrease antibiotic use in a tertiary care NICU.
