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

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

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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

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

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
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.",
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