Delivery-based criteria for empiric antibiotic administration among preterm infants.

TitleDelivery-based criteria for empiric antibiotic administration among preterm infants.
Publication TypeJournal Article
Year of Publication2020
AuthorsGarber SJ, Dhudasia MB, Flannery DD, Passarella MR, Puopolo KM, Mukhopadhyay S
JournalJ Perinatol
Date Published2020 Aug 13
ISSN1476-5543
Abstract

OBJECTIVE: Determine impact of using delivery criteria to initiate antibiotics among very low birth weight (VLBW) and extremely low birth weight (ELBW) infants. STUDY DESIGN: Single site cohort study from 01/01/2009 to 01/31/2020. After 04/2017, infants delivered by Cesarean section, without labor or membrane rupture were categorized as low-risk for early-onset infection and managed without empiric antibiotics. We determined effect of this guideline by pre-post, and interrupted time-series analyses.

RESULTS: After 04/2017, antibiotic initiation ≤3 days decreased among low-risk VLBW (62% vs. 13%, p < 0.001) and low-risk ELBW (88% vs. 21%, p < 0.001) infants. In time series analysis, guideline was associated with decreased initiation among low-risk ELBW infants. In contrast, low-risk VLBW infants demonstrated decreased antibiotic initiation throughout study period. Incidence of confirmed infection, death, or transfer ≤7 days age was unchanged.

CONCLUSION: Delivery criteria may be used to optimize early antibiotic initiation among preterm infants without short-term increase in adverse outcomes.

DOI10.1038/s41372-020-00784-y
Alternate JournalJ Perinatol
PubMed ID32792629
Grant ListT32HD060550 / / U.S. Department of Health & Human Services | NIH | Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) /
K23HD088753 / / U.S. Department of Health & Human Services | NIH | Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) /