title: Antimicrobial stewardship in the NICU.
abstract: There are unique challenges to antimicrobial stewardship in neonatal intensive care units (NICUs). Diagnosis of infection is difficult as neonates can have nonspecific signs and symptoms. Between and within NICUs, significant variation exists in the treatment duration of suspected sepsis and pneumonia. Development of multidisciplinary teams and meaningful metrics are essential for sustainable antibiotic stewardship. Potential stewardship interventions include optimizing culturing techniques, guiding empiric therapy by NICU-specific antibiograms, using ancillary laboratory tests, and promptly discontinuing therapy once infection is no longer suspected. Use of large neonatal databases can be used to benchmark antibiotic use and conduct comparative effectiveness research.
authors.affiliation: Division of Pediatric Infectious Disease, Department of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA; Division of Neonatal/Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA. Electronic address: Joseph.Cantey@UTSouthwestern.edu.
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Cantey
authors.affiliation: Division of Pediatric Infectious Diseases, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago Northwestern University Feinberg School of Medicine, 225 East Chicago Avenue, Box 20, Chicago, Illinois 60611-2605, USA.
authors.forename: Sameer J
authors.initials: SJ
authors.lastname: Patel
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000592:standards; D001424:Bacterial Infections / Q000188:drug therapy*; D002985:Clinical Protocols / Q000592:standards; D004352:Drug Resistance, Microbial; D006801:Humans; D057970:Inappropriate Prescribing / Q000517:prevention & control*; D007363:Intensive Care Units, Neonatal; D054539:Medication Therapy Management / Q000592:standards*; D009359:Neonatology / Q000379:methods; D018805:Sepsis / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antimicrobial; Metrics; Neonatal intensive care unit; Stewardship