Abstract:
OBJECTIVE: Previous analyses of neonatal intensive care units (NICU) antimicrobial stewardship programs have identified key contributors to overall antibiotic use, including prolonged empiric therapy >48 hours for early-onset sepsis (EOS). However, most were performed in mixed NICU settings with onsite birthing units, resulting in a high proportion of inborn patient admissions. The study aimed to describe and analyze the most common reasons for antimicrobial use in an outborn tertiary care NICU. STUDY DESIGN: This was a 10-month review of all antimicrobial doses prescribed in a 20-bed level III NICU. The primary outcome was the total days of therapy (DOT) and length of therapy (LOT) for each clinical indication. Secondary outcomes included total DOT for each antimicrobial and appropriateness of antimicrobial courses. RESULTS: Of 235 antibiotic courses and 1,899 DOT (519 DOT/1,000 patient days) prescribed in 173 infants during the study period, the most common indications were suspected EOS, followed by prophylaxis. Among the 85 DOT/1,000 patient days (PD; 38 courses) prescribed for prophylaxis, 52.5 DOT/1,000 PD (25 courses; 62%) were for surgical prophylaxis. Of 17 postoperative antibiotic courses, 15 (88.2%) were deemed to be inappropriate mostly due to a duration greater than 24 hours postoperatively (n = 13; median LOT = 3 days). CONCLUSION: Surgical prophylaxis is a common reason for antimicrobial misuse in outborn NICU. NICU-based prospective audit and feedback between neonatologists and antimicrobial stewardship teams alone may not be impactful in this setting. Partnerships with neonatologists and surgeons will be key to achieving the target of less than 24 hours of postoperative antimicrobials. KEY POINTS:· Surgical prophylaxis is a common reason for antimicrobial misuse in the NICU.. · Antimicrobial prophylaxis duration of less than 24 hours postoperatively should be encouraged.. · NICU-based prospective audit and feedback may not be impactful unless surgeons are involved..
journal_name
Am J Perinatoljournal_title
American journal of perinatologyauthors
Viel-Thériault I,Agarwal A,Bariciak E,Le Saux N,Thampi Ndoi
10.1055/s-0040-1722600subject
Has Abstractpub_date
2021-01-17 00:00:00eissn
0735-1631issn
1098-8785pub_type
杂志文章abstract::The ability of vibratory acoustic stimulation to shorten the duration of antepartum fetal heart rate monitoring was investigated by a randomized controlled trial. Vibratory acoustic stimulation did not shorten the overall duration of testing. This failure to improve the performance of antepartum monitoring appeared to...
journal_title:American journal of perinatology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1055/s-2007-999489
更新日期:1990-07-01 00:00:00
abstract::Diagnostic ultrasonography has given us the opportunity to diagnose several congenital malformations in utero. Skeletal dysplasias is a heterogeneous group of disorders of the skeleton. Although disorders of bone growth are often diagnosed in utero, it is usually a general diagnosis because the exact syndrome cannot b...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994638
更新日期:1993-03-01 00:00:00
abstract::External cephalic version should be followed by fetal and maternal surveillance until delivery. To shorten this period of surveillance, a protocol of version at term, followed by immediate induction of labor, was adopted. The aim of the present study was to evaluate the effect of this protocol on the subsequent mode o...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994508
更新日期:1995-11-01 00:00:00
abstract::Periventricular leukomalacia (PVL) is a complication of prematurity that carries a high risk of long-term neurologic morbidity. We report the first case, to our knowledge, of unexpected PVL associated with in utero methamphetamine exposure in a 30-week gestation premature infant with a benign hospital course, who subs...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-970079
更新日期:2007-02-01 00:00:00
abstract::The primary objective of this study was to determine whether having the sickle cell trait is independently associated with preeclampsia. We performed a retrospective cohort study of 1998 pregnant patients who either did or did not have the sickle cell trait. All patients were screened for the sickle trait using the "S...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2003-37953
更新日期:2003-01-01 00:00:00
abstract::Cord blood gas determinations were made on arterial and venous blood from 78 babies weighing less than 2000 gm at birth, including 52 weighing 1500 gm or less. Correlations were made with Apgar scores and intrapartum events as well as with birthweight (BW) and gestational age (GA). Significant differences were seen be...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999925
更新日期:1985-04-01 00:00:00
abstract:OBJECTIVE:Neonatal biomarkers of inflammation were examined in relation to early neurodevelopment and gait in very-low-birth-weight (VLBW) preterm children. We hypothesized that preterm infants exposed to higher levels of neonatal inflammation would demonstrate lower scores on Bayley Scales of Infant Toddler Developmen...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0035-1557106
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVE:We investigated the association between gestational weight gain (GWG) and postpartum depression (PPD) in women with class III obesity. STUDY DESIGN:This is a retrospective cohort of women with body mass index (BMI) ≥ 40 kg/m2 at entry to care, first prenatal visit ≤14 weeks gestation, with singleton, nonanom...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0039-1693989
更新日期:2020-01-01 00:00:00
abstract::Oxygenation instability is a very common problem in the premature infant that manifests as intermittent hypoxemia episodes (HEs). These are particularly frequent in premature infants who are on mechanical ventilation beyond the first weeks after birth. However, they can also occur in spontaneously breathing infants. S...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-0038-1637760
更新日期:2018-05-01 00:00:00
abstract:OBJECTIVE:We sought to examine pathogen distribution and clinical presentation of late-onset sepsis (LOS) at an urban tertiary care center. STUDY DESIGN:We performed a retrospective review of all culture-confirmed cases of LOS presenting to our institution from 2013 to 2017. Medical records were evaluated for demograp...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1675643
更新日期:2019-09-01 00:00:00
abstract::The effect of active management on latent phase labor was assessed in 197 consecutive nulliparous women. Active management resulted in a significant shortening of the latent phase but had no effect on active phase labor. Patients undergoing induction of labor had latent phases that were almost identical to the accepte...
journal_title:American journal of perinatology
pub_type: 临床试验,杂志文章
doi:10.1055/s-2007-999524
更新日期:1990-10-01 00:00:00
abstract::Intra-amniotic infection is often the cause of a second-trimester abortion. The bacterial species involved include bacteria with low pathogenicity like Ureaplasma urealyticum and various Mycoplasma species. In this case we describe an intra-amniotic infection caused by Capnocytophaga sputigena, often found in the norm...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-993854
更新日期:1999-01-01 00:00:00
abstract::The numbers of ectopic pregnancies have increased because of the popularization of assisted reproductive techniques. However, the retroperitoneal space is an exceptional location for ectopic pregnancy because the entrance to the retroperitoneal space is unknown. A woman 31 years of age who had received bilateral salpi...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-1004829
更新日期:2008-01-01 00:00:00
abstract::The objective of this study was to perform antiphospholipid antibody screening in women with chronic hypertension to assess whether the presence of such antibodies is associated with adverse pregnancy outcome. Serum for anticardiolipin antibodies and lupus anticoagulant was obtained in pregnant women with chronic hype...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2004-829870
更新日期:2004-07-01 00:00:00
abstract::There were 107 episodes of pyelonephritis associated with pregnancy or the early puerperium occurring in 103 gravidas investigated retrospectively for information concerning prematurity, low birthweight, and antibiotic susceptibility patterns in the recovered microorganisms. No difference was found in the incidence of...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999800
更新日期:1987-10-01 00:00:00
abstract::We report the case of a term male infant with severe persistent pulmonary hypertension of the newborn, who developed massive neutrophilia of unknown etiology. An extensive evaluation failed to disclose an obvious cause for his neutrophilia. A bone marrow aspirate was performed and was consistent with a leukemoid react...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-2003-45288
更新日期:2003-10-01 00:00:00
abstract::The aim of the study was to investigate the effect of individual room care in the neonatal intensive care unit (NICU) on the factors that influence mother-preterm infant interaction. Mothers in group I had hospitalization with their preterm infants in an individual room in the NICU. Mothers in group II were not hospit...
journal_title:American journal of perinatology
pub_type: 杂志文章,多中心研究
doi:10.1055/s-0028-1095186
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVE:The aim of the study is to determine if umbilical cord serum concentrations of interleukin-6 (IL-6), C-reactive protein (CRP), and myeloperoxidase (MPO), in pregnancies at risk for preterm birth (PTB), are associated with neonatal morbidities and/or altered neurodevelopmental outcomes in the children. STUDY ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0033-1359723
更新日期:2014-09-01 00:00:00
abstract::The objective of this paper is to determine if phenobarbital exposure during pregnancy affects developmental outcome at age 2 years. Between 1991 and 1994, 401 pregnant patients at risk for delivery prior to 34 weeks' gestation were invited to participate; 48 mothers declined entry. Before delivery, pharmacy randomize...
journal_title:American journal of perinatology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1055/s-2007-993836
更新日期:1999-01-01 00:00:00
abstract:OBJECTIVE: The aim of this study is to evaluate formal bereavement debriefing sessions after infant death on neonatal intensive care unit (NICU) staff. STUDY DESIGN: Prospective mixed methods study. Pre- and postbereavement debriefing intervention surveys were sent to clinical staff. Evaluation surveys were distribute...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1716481
更新日期:2020-09-07 00:00:00
abstract:OBJECTIVE:To evaluate whether tocolysis with nifedipine can be omitted in women with symptoms of preterm labor, a shortened cervix, and negative fetal fibronectin test. STUDY DESIGN:A randomized noninferiority trial was performed in all Dutch perinatal centers. Women with symptoms of preterm labor between 24 and 34 we...
journal_title:American journal of perinatology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1055/s-0034-1390346
更新日期:2015-04-01 00:00:00
abstract::Objective There is limited data regarding the use of oral hypoglycemic agents (OHAs) in pregnant women with type 2 diabetes mellitus (T2DM). Study Design This was a retrospective cohort study of women with T2DM who were treated with OHA or insulin from the first trimester onward. Bivariate and multivariate logistic re...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0036-1597625
更新日期:2017-06-01 00:00:00
abstract::Molecular amplification of parvovirus B19 DNA in an amniotic fluid sample was used to confirm the etiologic agent of a case with fetal hydrops. The polymerase chain reaction (PCR) method used is easy and fast to perform. We have a 2-year experience on its use in clinical parvovirus B19 diagnosis. The results are avail...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994518
更新日期:1995-11-01 00:00:00
abstract::Surfactants have been routinely used since 1990 for the treatment of respiratory distress syndrome (RDS). The use of surfactant has coincided with a decrease in mortality in infants due to RDS. This review focuses on clinical aspects of surfactant use. New information, particularly effects of ventilatory styles on sur...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-2000-13445
更新日期:2000-01-01 00:00:00
abstract::During normal pregnancy there is a decrease in the hematocrit due to a disproportionate increase in the blood volume compared with the red cell mass. Using a new enzyme-linked immunoassay (Amgen Diagnostics), serum erythropoietin was quantified in normal nonanemic pregnancies throughout gestation and in third trimeste...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994778
更新日期:1992-07-01 00:00:00
abstract::A 27-year-old primigravida women was referred for ultrasound studies at 32 weeks' gestation because of the suspicion of fetal ventriculomegaly. Sonographic examination of the fetal brain found a marked shift of the midline, with enlarged left hemisphere and ipsilateral occipital horn, and abnormal convolutions. A 3500...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999330
更新日期:1991-01-01 00:00:00
abstract::Novel coronavirus disease 2019 (COVID-19) infection occurring during pregnancy is associated with an increased risk of preterm delivery. This case report describes successful treatment of preterm labor during acute COVID-19 infection. Standard treatment for preterm labor may allow patients with acute COVID-19 infectio...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1709993
更新日期:2020-06-01 00:00:00
abstract::One hundred twenty-one patients underwent an ultrasound examination within 48 hours of delivery to assess prospectively the reliability of the diagnosis of intrauterine growth retardation. Sonographic parameters examined included the abdominal circumference, sonographic estimate of fetal weight, the head to abdominal ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999622
更新日期:1989-10-01 00:00:00
abstract::Infants of diabetic mothers (IDMs) are at known risk for developing a hypertrophic type of cardiomyopathy. The severity of IDM cardiomyopathy can vary from an incidental finding on echocardiography to an infant with severe symptoms of congestive heart failure. The purpose of this article is to review the pathophysiolo...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-2007-999722
更新日期:1988-10-01 00:00:00
abstract:OBJECTIVE: Transient tachypnoea of the newborn (TTN) is one of the most common causes of neonatal respiratory distress (RD) during the newborn period. Chest radiography (CXR) is commonly used to rule out the diagnosis, but TTN is often misdiagnosed as neonatal respiratory distress syndrome (NRDS) on the basis of CXR al...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1721134
更新日期:2020-11-26 00:00:00