Reduction of antibacterial use in patients with very low birth weight on German NICUs after implementation of a mandatory surveillance system. A longitudinal study with national data from 2013 to 2019. Issue 1 (July 2022)

• Record Type: Journal Article
• Authors: Kramer, Tobias Siegfried; Salm, Florian; Schwab, Frank; Geffers, Christine; Behnke, Michael; Gastmeier, Petra; Piening, Brar
• Is Part Of: Journal of infection. Volume 85:Issue 1(2022)
• Page Start: 8
• Page End: 16
• Publication Date: 2022-07
• Subjects: Antibacterial consumption -- Surveillance -- Antimicrobial stewardship -- Days of therapy -- Days of treatment -- Neonatal -- Preterm -- NICU -- Very low birth weight; Infection -- Periodicals; Bacterial Infections -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.905
• DOI: 10.1016/j.jinf.2022.05.009
• Languages: English
• ISSNs: 0163-4453

Abstract

Highlights: Introduction of a mandatory national surveillance system is associated with decrease in antibacterial use on NICU. The use of penicillins with extended spectrum, aminoglycosides, glycopeptides and third-generation cephalosporins decreased over time. Use of macrolides and penicillins combined with beta-lactamase inhibitors increased over time. Summary: Objectives: To determine the influence of a national surveillance system for neonates (NEO-KISS) in neonatal intensive care units (NICUs) on consumption of antibacterial and to identify risk factors for prescriptions. Methods: Data on antibacterial use between 2013 and 2019 from 231 NICUs in Germany was analyzed in this longitudinal study after introduction of a mandatory module for surveillance of antibacterial consumption in preterm infants. 59, 411 newborns with a birth weight under 1500 gs were under surveillance in NEO-KISS during the study period. We report the development of antibacterial consumption during the days of treatment (DOT)/1000 patient days (PD) including the name of the substance administered. Risk factors for antibacterial treatment over time were analyzed. Results: A total, 2, 090, 341 surveillance patient days were monitored. Antibacterial consumption was 430.4 DOT/1000PD (Median 380.3; IQR: 284.2–502.7). Antibacterial use significantly decreased by 19.5% from 2013, 474.3 DOT/1000PD to 382.1 DOT/1000PD in 2019. Use of penicillins with extended spectrum (J01CA), other aminoglycosides (J01GB), glycopeptide antibacterials (J01XA and J01DH), and third-generation cephalosporins (J01DD) decreased, while use of macrolides (J01FA) and combinations of penicillins, including beta-lactamase inhibitors (J01CR), increased over time. Regression analysis identified year of birth as an independent protective factor for the prescription of antibacterials in general. Conclusion: The implementation of a national mandatory surveillance system was associated with a reduction in antibacterial consumption in preterm infants with VLBW. Surveillance of antibacterial use is an integral part of targeting antimicrobial stewardship efforts.