Decreased Antibiotic Exposure for Suspected Early-Onset Sepsis in the Neonatal Intensive Care Unit Through Implementation of an Antimicrobial Time-out

Abstract

Antimicrobials are among the most frequently prescribed drugs in the neonatal intensive care unit (NICU), although most neonates exposed lack a bacterial infection. Overuse of antimicrobials carries risk to the patient and fosters the development of resistant organisms. Strategic and systematic processes hold promise to limit the unnecessary use of these drugs in this population. This study reports a quality improvement initiative in which 2 antimicrobial stewardship strategies were implemented in a large, regional NICU setting: an automatic stop order and an antimicrobial time-out. Antimicrobial use was compared before and after implementation. These 2 simple strategies were associated with a nearly 30% reduction in antibiotic use (31 days per 1000 patient days).