Surviving Sepsis in a Referral Neonatal Intensive Care Unit: Association between Time to Antibiotic Administration and In-Hospital Outcomes - 22/01/20
Abstract |
Objective |
To determine if time to antibiotic administration is associated with mortality and in-hospital outcomes in a neonatal intensive care unit (NICU) population.
Study design |
We conducted a prospective evaluation of infants with suspected sepsis between September 2014 and February 2018; sepsis was defined as clinical concern prompting blood culture collection and antibiotic administration. Time to antibiotic administration was calculated from time of sepsis identification, defined as the order time of either blood culture or an antibiotic, to time of first antibiotic administration. We used linear models with generalized estimating equations to determine the association between time to antibiotic administration and mortality, ventilator-free and inotrope-free days, and NICU length of stay in patients with culture-proven sepsis.
Results |
Among 1946 sepsis evaluations, we identified 128 episodes of culture-proven sepsis in 113 infants. Among them, prolonged time to antibiotic administration was associated with significantly increased risk of mortality at 14 days (OR, 1.47; 95% CI, 1.15-1.87) and 30 days (OR, 1.47; 95% CI, 1.11-1.94) as well as fewer inotrope-free days (incidence rate ratio, 0.91; 95% CI, 0.84-0.98). No significant associations with ventilator-free days or NICU length of stay were demonstrated.
Conclusions |
Among infants with sepsis, delayed time to antibiotic administration was an independent risk factor for death and prolonged cardiovascular dysfunction. Further study is needed to define optimal timing of antimicrobial administration in high-risk NICU populations.
Le texte complet de cet article est disponible en PDF.Keywords : infection, infants, antibiotics, mortality, morbidity
Abbreviations : CHOP, CLD, NICU, EHR, NEC
Plan
Supported by CareFusion, Inc, and the Institute for Biomedical Informatics, University of Pennsylvania School of Medicine. The authors declare no conflicts of interest. |
|
Portions of this study were presented as a poster at the Eastern Society for Pediatric Research, March 2018, Philadelphia, PA, and Society for Pediatric Research at the Pediatric Academic Society Annual Meeting, May 2018, Toronto, Ontario, Canada. |
Vol 217
P. 59 - février 2020 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?