Antimicrobial therapy utilization in neonates with hypoxic-ischemic encephalopathy (HIE): a report from the Children’s Hospital Neonatal Database (CHND)

Rakesh Rao*, Kyong Soon Lee, Isabella Zaniletti, Toby D. Yanowitz, Robert DiGeronimo, Maria L.V. Dizon, Shannon E. Hamrick, Girija Natarajan, Eric S. Peeples, Karna Murthy, Amit M. Mathur, An Massaro

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Objective(s): Quantify antimicrobial therapy (AMT) use in newborns with hypoxic-ischemic encephalopathy treated with therapeutic hypothermia (HIE/TH). Study design: Newborns with HIE/TH were identified from the Children’s Hospital Neonatal Database (CHND). Early infection (onset ≤7 days of life) was defined as “confirmed” (culture proven) or “suspected infection” (culture negative but treated) and compared with a “no infection” group. Results: 1501/1534 (97.8%) neonates received AMT. 36 (2.3%) had confirmed, 255 (16.6%) suspected, and 1243 (81.0%) had no infection. The median (IQR) AMT duration was 13 (8–21), 8 (7–10), and 3 (3–7) days for the three groups, respectively (p < 0.001). AMT duration of use varied significantly across centers, adjusted for covariates (OR 1.88, 95% CI: 1.43–2.46). Conclusion(s): Incidence of early confirmed infection in neonates with HIE/TH (23/1000) is significantly higher than reported rates of early onset sepsis in term and near term infants (0.5–1.0/1000 live births). Antimicrobial-stewardship opportunities exist in infants with negative cultures.

Original languageEnglish (US)
Pages (from-to)70-78
Number of pages9
JournalJournal of Perinatology
Volume40
Issue number1
DOIs
StatePublished - Jan 1 2020

Fingerprint

Brain Hypoxia-Ischemia
Newborn Infant
Databases
Infection
Therapeutics
Induced Hypothermia
Live Birth
Sepsis
Incidence

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Rao, Rakesh ; Lee, Kyong Soon ; Zaniletti, Isabella ; Yanowitz, Toby D. ; DiGeronimo, Robert ; Dizon, Maria L.V. ; Hamrick, Shannon E. ; Natarajan, Girija ; Peeples, Eric S. ; Murthy, Karna ; Mathur, Amit M. ; Massaro, An. / Antimicrobial therapy utilization in neonates with hypoxic-ischemic encephalopathy (HIE) : a report from the Children’s Hospital Neonatal Database (CHND). In: Journal of Perinatology. 2020 ; Vol. 40, No. 1. pp. 70-78.
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abstract = "Objective(s): Quantify antimicrobial therapy (AMT) use in newborns with hypoxic-ischemic encephalopathy treated with therapeutic hypothermia (HIE/TH). Study design: Newborns with HIE/TH were identified from the Children’s Hospital Neonatal Database (CHND). Early infection (onset ≤7 days of life) was defined as “confirmed” (culture proven) or “suspected infection” (culture negative but treated) and compared with a “no infection” group. Results: 1501/1534 (97.8{\%}) neonates received AMT. 36 (2.3{\%}) had confirmed, 255 (16.6{\%}) suspected, and 1243 (81.0{\%}) had no infection. The median (IQR) AMT duration was 13 (8–21), 8 (7–10), and 3 (3–7) days for the three groups, respectively (p < 0.001). AMT duration of use varied significantly across centers, adjusted for covariates (OR 1.88, 95{\%} CI: 1.43–2.46). Conclusion(s): Incidence of early confirmed infection in neonates with HIE/TH (23/1000) is significantly higher than reported rates of early onset sepsis in term and near term infants (0.5–1.0/1000 live births). Antimicrobial-stewardship opportunities exist in infants with negative cultures.",
author = "Rakesh Rao and Lee, {Kyong Soon} and Isabella Zaniletti and Yanowitz, {Toby D.} and Robert DiGeronimo and Dizon, {Maria L.V.} and Hamrick, {Shannon E.} and Girija Natarajan and Peeples, {Eric S.} and Karna Murthy and Mathur, {Amit M.} and An Massaro",
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Rao, R, Lee, KS, Zaniletti, I, Yanowitz, TD, DiGeronimo, R, Dizon, MLV, Hamrick, SE, Natarajan, G, Peeples, ES, Murthy, K, Mathur, AM & Massaro, A 2020, 'Antimicrobial therapy utilization in neonates with hypoxic-ischemic encephalopathy (HIE): a report from the Children’s Hospital Neonatal Database (CHND)', Journal of Perinatology, vol. 40, no. 1, pp. 70-78. https://doi.org/10.1038/s41372-019-0527-2

Antimicrobial therapy utilization in neonates with hypoxic-ischemic encephalopathy (HIE) : a report from the Children’s Hospital Neonatal Database (CHND). / Rao, Rakesh; Lee, Kyong Soon; Zaniletti, Isabella; Yanowitz, Toby D.; DiGeronimo, Robert; Dizon, Maria L.V.; Hamrick, Shannon E.; Natarajan, Girija; Peeples, Eric S.; Murthy, Karna; Mathur, Amit M.; Massaro, An.

In: Journal of Perinatology, Vol. 40, No. 1, 01.01.2020, p. 70-78.

Research output: Contribution to journalArticle

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T2 - a report from the Children’s Hospital Neonatal Database (CHND)

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AU - Lee, Kyong Soon

AU - Zaniletti, Isabella

AU - Yanowitz, Toby D.

AU - DiGeronimo, Robert

AU - Dizon, Maria L.V.

AU - Hamrick, Shannon E.

AU - Natarajan, Girija

AU - Peeples, Eric S.

AU - Murthy, Karna

AU - Mathur, Amit M.

AU - Massaro, An

PY - 2020/1/1

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N2 - Objective(s): Quantify antimicrobial therapy (AMT) use in newborns with hypoxic-ischemic encephalopathy treated with therapeutic hypothermia (HIE/TH). Study design: Newborns with HIE/TH were identified from the Children’s Hospital Neonatal Database (CHND). Early infection (onset ≤7 days of life) was defined as “confirmed” (culture proven) or “suspected infection” (culture negative but treated) and compared with a “no infection” group. Results: 1501/1534 (97.8%) neonates received AMT. 36 (2.3%) had confirmed, 255 (16.6%) suspected, and 1243 (81.0%) had no infection. The median (IQR) AMT duration was 13 (8–21), 8 (7–10), and 3 (3–7) days for the three groups, respectively (p < 0.001). AMT duration of use varied significantly across centers, adjusted for covariates (OR 1.88, 95% CI: 1.43–2.46). Conclusion(s): Incidence of early confirmed infection in neonates with HIE/TH (23/1000) is significantly higher than reported rates of early onset sepsis in term and near term infants (0.5–1.0/1000 live births). Antimicrobial-stewardship opportunities exist in infants with negative cultures.

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