Antibiotic stewardship in premature infants: a systematic review
| Autor: | Ola Didrik Saugstad, Anirban Dutta, Fernanda Cristina Petersen, Gorm Greisen, Dag Berild, Kirsti Haaland, Sushma Nangia, Polona Rajar, Sharmila S. Mande, Ulf R Dahle, Ulrik Lausten-Thomsen |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.drug_class Antibiotics Population MEDLINE law.invention 03 medical and health sciences 0302 clinical medicine Antibiotic resistance Randomized controlled trial Adverse health effect law Antibiotic therapy 030225 pediatrics Intensive care Medicine 030212 general & internal medicine Intensive care medicine education education.field_of_study business.industry Antibiotic exposure Systematic review Cohort Pediatrics Perinatology and Child Health Antibiotic Stewardship Observational study Stewardship business Developmental Biology |
| Zdroj: | Neonatology Rajar, P, Saugstad, O D, Berild, D, Dutta, A, Greisen, G, Lausten-Thomsen, U, Mande, S S, Nangia, S, Petersen, F C, Dahle, U R & Haaland, K 2020, ' Antibiotic Stewardship in Premature Infants : A Systematic Review ', Neonatology, vol. 117, no. 6, pp. 673-686 . https://doi.org/10.1159/000511710 |
| ISSN: | 1661-7800 |
| Popis: | Introduction: Antibiotic treatment in premature infants is often empirically prescribed, and practice varies widely among otherwise comparable neonatal intensive care units. Unnecessary and prolonged antibiotic treatment is documented in numerous studies. Recent research shows serious side effects and suggests long-term adverse health effects in prematurely born infants exposed to antibiotics in early life. One preventive measure to reduce unnecessary antibiotic exposure is implementation of antibiotic stewardship programs. Our objective was to review the literature on implemented antibiotic stewardship programs including premature infants with gestational age ≤34 weeks. Methods: Six academic databases (PubMed [Medline], McMaster PLUS, Cochrane Database of Systematic Reviews, UpToDate, Cochrane Central Register of Controlled Trials, and National Institute for Health and Care Excellence) were systematically searched. PRISMA guidelines were applied. Results: The search retrieved 1,212 titles of which 12 fitted inclusion criteria (11 observational studies and 1 randomized clinical trial). Included articles were critically appraised. We grouped the articles according to common area of implemented stewardship actions: (1) focus on reducing initiation of antibiotic therapy, (2) focus on shortening duration of antibiotic therapy, (3) various organizational stewardship implementations. The heterogeneity of cohort composition, of implemented actions and of outcome measures made meta-analysis inappropriate. We provide an overview of the reduction in antibiotic use achieved. Conclusion: Antibiotic stewardship programs can be effective for premature newborns especially when multifactorial and tailored to this population, focusing on reducing initiation or on shortening the duration of antibiotic therapy. Programs without specific measures were less effective. |
| Databáze: | OpenAIRE |
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