A global point prevalence survey of antimicrobial use in neonatal intensive care units : the no-more-antibiotics and resistance (NO-MAS-R) study
dc.contributor.author | Prusakov, Pavel | pt_BR |
dc.contributor.author | Sánchez, Pablo J. | pt_BR |
dc.contributor.author | Silveira, Rita de Cássia dos Santos | pt_BR |
dc.contributor.author | Global NEO-ASP Study Group | pt_BR |
dc.date.accessioned | 2022-07-20T04:49:03Z | pt_BR |
dc.date.issued | 2021 | pt_BR |
dc.identifier.issn | 2589-5370 | pt_BR |
dc.identifier.uri | http://hdl.handle.net/10183/243195 | pt_BR |
dc.description.abstract | Background: Global assessment of antimicrobial agents prescribed to infants in the neonatal intensive care unit (NICU) may inform antimicrobial stewardship efforts. Methods: We conducted a one-day global point prevalence study of all antimicrobials provided to NICU infants. Demographic, clinical, and microbiologic data were obtained including NICU level, census, birth weight, gestational/chronologic age, diagnoses, antimicrobial therapy (reason for use; length of therapy), antimicrobial stewardship program (ASP), and 30-day in-hospital mortality. Findings: On July 1, 2019, 26% of infants (580/2,265; range, 0 100%; median gestational age, 33 weeks; median birth weight, 1800 g) in 84 NICUs (51, high-income; 33, low-to-middle income) from 29 countries (14, high-income; 15, low-to-middle income) in five continents received >=1 antimicrobial agent (92%, antibacterial; 19%, antifungal; 4%, antiviral). The most common reasons for antibiotic therapy were “rule-out” sepsis (32%) and “culture-negative” sepsis (16%) with ampicillin (40%), gentamicin (35%), amikacin (19%), vancomycin (15%), and meropenem (9%) used most frequently. For definitive treatment of presumed/confirmed infection, vancomycin (26%), amikacin (20%), and meropenem (16%) were the most prescribed agents. Length of therapy for culture-positive and “culture-negative” infections was 12 days (median; IQR, 8-14) and 7 days (median; IQR, 5-10), respectively. Mortality was 6% (42%, infection-related). An NICU ASP was associated with lower rate of antibiotic utilization (p = 0.02). Interpretation: Global NICU antibiotic use was frequent and prolonged regardless of culture results. NICU-specific ASPs were associated with lower antibiotic utilization rates, suggesting the need for their implementation worldwide. | en |
dc.format.mimetype | application/pdf | pt_BR |
dc.language.iso | eng | pt_BR |
dc.relation.ispartof | EClinicalMedicine. [London]. Vol. 32 (2021), 100727, 12 p. | pt_BR |
dc.rights | Open Access | en |
dc.subject | Global point prevalence study | en |
dc.subject | Estudos transversais | pt_BR |
dc.subject | Tétano | pt_BR |
dc.subject | Neonatal infection | en |
dc.subject | Neonatal antimicrobial stewardship | en |
dc.subject | Gestão de antimicrobianos | pt_BR |
dc.subject | Neonatologia | pt_BR |
dc.subject | Antibiotics | en |
dc.subject | Antibacterianos | pt_BR |
dc.subject | Antifungal | en |
dc.subject | Antifúngicos | pt_BR |
dc.title | A global point prevalence survey of antimicrobial use in neonatal intensive care units : the no-more-antibiotics and resistance (NO-MAS-R) study | pt_BR |
dc.type | Artigo de periódico | pt_BR |
dc.identifier.nrb | 001144745 | pt_BR |
dc.type.origin | Estrangeiro | pt_BR |
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