Antibiotic Use Varies Widely at Calif. Neonatal Intensive Care Units
Details of Study
For the study, researchers examined 52,061 infants across 127 California NICUs for:
- Annual antibiotic use rate; and
- The number of days that infants received at least one antibacterial or antifungal agent during every 100 days of being a patient (Henderson, Medscape, 4/20).
Researchers also sought to determine whether there was a link between antibiotic use and:
- Length of hospital stays;
- Mortality rates;
- Rates of proven infection;
- Serious complication rates of prematurity; and
- Surgery volumes (Digitale, "Scope," Stanford Medicine, 4/27).
According to the study, annual antibiotic use rates among the California NICUs ranged from 2.4% of patient-days to 97.1% of patient-days.
In addition, the study found that intermediate-level NICUs had the highest antibiotic use rates, while about half reported infection rates of 0%.
Meanwhile, the study found no link between antibiotic use and mortality rates, proven infection, serious complications of prematurity or surgery volume.
The researchers wrote, "Variation in antibiotic prescribing practice appears to hinge on variation in how practitioners frame, interpret and respond to clinical situations ultimately considered unproven infection" and therefore "a considerable portion of the observed variation appears [to be] unwarranted."
The study authors suggested that clinical thresholds for prescribing or continuing antibiotics could "be raised without harm."
They added that annual antibiotic use rates should be used to measure NICU performance (Medscape, 4/20).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.