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Delivery-based criteria for empiric antibiotic administration among preterm infants
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Delivery-based criteria for empiric antibiotic administration among preterm infants
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Delivery-based criteria for empiric antibiotic administration among preterm infants
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Journal Article
Delivery-based criteria for empiric antibiotic administration among preterm infants
2021
Overview
ObjectiveDetermine impact of using delivery criteria to initiate antibiotics among very low birth weight (VLBW) and extremely low birth weight (ELBW) infants.Study designSingle 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.ResultsAfter 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.ConclusionDelivery criteria may be used to optimize early antibiotic initiation among preterm infants without short-term increase in adverse outcomes.
