Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

CDC Infant Antibiotic Guidelines vs Actual Practices

Pediatrics; ePub 2018 Nov 20; Ho, Buus-Frank, et al

Significant gaps exist between Centers for Disease Control (CDC) recommendations to improve antibiotic use and antibiotic practices during the newborn period, according to a recent investigation. There is wide variation in point prevalence antibiotic use rates (AURs) and three-quarters of infants who received antibiotics for >48 hours did not have infections proven by using cultures. Data were collected using a cross-sectional audit of Vermont Oxford Network members in February 2016. Unit measures were derived from the 7 domains of the CDC’s Core Elements of Hospital Antibiotic Stewardship Programs, including leadership commitment, accountability, drug expertise, action, tracking, reporting, and education. Researchers found:

  • Overall, 143 centers completed structured self-assessments.
  • No center addressed all 7 core elements.
  • Of the 7, only accountability (55%) and drug expertise (62%) had compliance >50%.
  • Centers audited 4,127 infants for current antibiotic exposure.
  • There were 725 infants who received antibiotics, for a hospital median AUR of 17% (interquartile range 10%–26%).
  • Of the 412 patients on >48 hours of antibiotics, only 26% (107 out of 412) had positive culture results.

Ho T, Buus-Frank ME, Edwards EM, et al. Adherence of newborn-specific antibiotic stewardship programs to CDC recommendations. [Published online ahead of print November 20, 2018]. Pediatrics. doi:10.1542/peds.2017-4322.

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