Prusakov, PavelGoff, Debra AWozniak, Phillip SCassim, AzraaScipion, Catherine E AUrzúa, SoledadRonchi, AndreaZeng, LingkongLadipo-Ajayi, OluwaseunAviles-Otero, NoeliaUdeigwe-Okeke, Chisom RMelamed, RimmaSilveira, Rita CAuriti, CinziaBeltrán-Arroyave, ClaudiaZamora-Flores, ElenaSanchez-Codez, MariaDonkor, Eric SKekomäki, SatuMainini, NicolettaTrochez, Rosalba VivasCasey, JamalynGraus, Juan MMuller, MallorySingh, SaraLoeffen, YvettePérez, María Eulalia TamayoFerreyra, Gloria IsabelLima-Rogel, VictoriaPerrone, BarbaraIzquierdo, GianninaCernada, MaríaStoffella, SylviaEkenze, Sebastian Okwuchukwude Alba-Romero, ConcepciónTzialla, ChryssoulaPham, Jennifer THosoi, KenichiroConsuegra, Magdalena Cecilia CaleroBetta, PasquaHoyos, O AlvaroRoilides, EmmanuelNaranjo-Zuñiga, GabrielaOshiro, MakotoGaray, VictorMondì, VitoMazzeo, DanilaStahl, James ACantey, Joseph BMonsalve, Juan Gonzalo MesaNormann, ErikLandgrave, Lindsay CMazouri, AliAvila, Claudia AlarcónPiersigilli, FiammettaTrujillo, MonicaKolman, SonyaDelgado, VerónicaGuzman, VeronicaAbdellatif, MohamedMonterrosa, LuisTina, Lucia GabriellaYunis, KhalidRodriguez, Marco Antonio BelzuSaux, Nicole LeLeonardi, ValentinaPorta, AlessandroLatorre, GiuseppeNakanishi, HidehikoMeir, MichalManzoni, PaoloNorero, XimenaHoyos, AngelaArias, DianaSánchez, Rubén GarcíaMedoro, Alexandra KSánchez, Pablo JGlobal NEO-ASP Study Group2023-02-092023-02-092021-01-29http://hdl.handle.net/10668/17119Global 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.enAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/AntibioticsAntifungalGlobal point prevalence studyNeonatal antimicrobial stewardshipNeonatal infectionresearch article33554094open access10.1016/j.eclinm.2021.1007272589-5370PMC7848759http://www.thelancet.com/article/S2589537021000079/pdfhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7848759/pdf