%0 Journal Article
%A Prusakov, Pavel
%A Goff, Debra A
%A Wozniak, Phillip S
%A Cassim, Azraa
%A Scipion, Catherine E A
%A Urzúa, Soledad
%A Ronchi, Andrea
%A Zeng, Lingkong
%A Ladipo-Ajayi, Oluwaseun
%A Aviles-Otero, Noelia
%A Udeigwe-Okeke, Chisom R
%A Melamed, Rimma
%A Silveira, Rita C
%A Auriti, Cinzia
%A Beltrán-Arroyave, Claudia
%A Zamora-Flores, Elena
%A Sanchez-Codez, Maria
%A Donkor, Eric S
%A Kekomäki, Satu
%A Mainini, Nicoletta
%A Trochez, Rosalba Vivas
%A Casey, Jamalyn
%A Graus, Juan M
%A Muller, Mallory
%A Singh, Sara
%A Loeffen, Yvette
%A Pérez, María Eulalia Tamayo
%A Ferreyra, Gloria Isabel
%A Lima-Rogel, Victoria
%A Perrone, Barbara
%A Izquierdo, Giannina
%A Cernada, María
%A Stoffella, Sylvia
%A Ekenze, Sebastian Okwuchukwu
%A de Alba-Romero, Concepción
%A Tzialla, Chryssoula
%A Pham, Jennifer T
%A Hosoi, Kenichiro
%A Consuegra, Magdalena Cecilia Calero
%A Betta, Pasqua
%A Hoyos, O Alvaro
%A Roilides, Emmanuel
%A Naranjo-Zuñiga, Gabriela
%A Oshiro, Makoto
%A Garay, Victor
%A Mondì, Vito
%A Mazzeo, Danila
%A Stahl, James A
%A Cantey, Joseph B
%A Monsalve, Juan Gonzalo Mesa
%A Normann, Erik
%A Landgrave, Lindsay C
%A Mazouri, Ali
%A Avila, Claudia Alarcón
%A Piersigilli, Fiammetta
%A Trujillo, Monica
%A Kolman, Sonya
%A Delgado, Verónica
%A Guzman, Veronica
%A Abdellatif, Mohamed
%A Monterrosa, Luis
%A Tina, Lucia Gabriella
%A Yunis, Khalid
%A Rodriguez, Marco Antonio Belzu
%A Saux, Nicole Le
%A Leonardi, Valentina
%A Porta, Alessandro
%A Latorre, Giuseppe
%A Nakanishi, Hidehiko
%A Meir, Michal
%A Manzoni, Paolo
%A Norero, Ximena
%A Hoyos, Angela
%A Arias, Diana
%A Sánchez, Rubén García
%A Medoro, Alexandra K
%A Sánchez, Pablo J
%A Global NEO-ASP Study Group
%T A global point prevalence survey of antimicrobial use in neonatal intensive care units: The no-more-antibiotics and resistance (NO-MAS-R) study.
%D 2021
%U http://hdl.handle.net/10668/17119
%X Global assessment of antimicrobial agents prescribed to infants in the neonatal intensive care unit (NICU) may inform antimicrobial stewardship efforts. 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. 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). 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. Merck & Co.; The Ohio State University College of Medicine Barnes Medical Student Research Scholarship.
%K Antibiotics
%K Antifungal
%K Global point prevalence study
%K Neonatal antimicrobial stewardship
%K Neonatal infection
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