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
Publication statusPublished - Jan 1 2020

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ASJC Scopus subject areas

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

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