Antibiotic Stewardship in the Neonatal Intensive Care Unit: A Quality Improvement Project
No Thumbnail Available
Background of Problem: Antibiotic stewardship, including identifying appropriate timing, type, and duration of antibiotic use, is important in order to reduce adverse events associated with antibiotic use in the Neonatal Intensive Care Unit (NICU). Variation exists in the selection and duration of empiric antibiotics in both preterm and term neonates suspected of sepsis.|Purpose of Change: The purpose of this project was to decrease exposure of neonates to empiric use of broad-spectrum (3rd and 4th generation) cephalosporins and to reduce the unnecessary use of cephalosporins by 25% over a six-month time frame.|Practice Change Methods: A retrospective analysis of empiric antibiotic (cephalosporin) use and duration of 50 randomly selected patients over a three-month time frame in the NICU. A survey was sent to providers regarding their choice/duration of antibiotics. Implementation of an Antibiotic Stewardship Program (ASP) based on a current review data and literature.|Results: Following ASP implementation there was a reduction from 82% (baseline) random use of empiric cephalosporin to 5% (post-implementation). This result was statistically significant with a p-value of <0.0001. The reduction in the use of cephalosporins also reduced costs by $663.00 over a six-month period.|Implications for Practice: As identified by research the reduction in the overuse of antibiotics is one of the most effective ways to improve quality of patient care and reduce overall costs.|Implications for Research: Further analysis can be completed following this implementation to evaluate further benefits from this evidence-based practice change.
Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University