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Search All Research Studies
Topics
- (-) Antibiotics (12)
- Antimicrobial Stewardship (3)
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- Comparative Effectiveness (1)
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- Evidence-Based Practice (1)
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- Imaging (1)
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- Intensive Care Unit (ICU) (4)
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- Medication (11)
- Neonatal Intensive Care Unit (NICU) (2)
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- Pneumonia (1)
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- Respiratory Conditions (2)
- Risk (2)
- Sepsis (2)
- Urinary Tract Infection (UTI) (3)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 12 of 12 Research Studies DisplayedQureshi N, Kroger J, Zangwill KM
Changes in perceptions of antibiotic stewardship among neonatal intensive care unit providers over the course of a learning collaborative: a prospective, multisite, mixed-methods evaluation.
The purpose of this study was to assess clinician perceptions towards the value and implementation of antibiotic stewardship (AS) in neonatal intensive care units (NICU). The researchers conducted a mixed-methods study of AS perceptions utilizing surveys and interviews in 30 California NICUs before and after a multicenter collaborative (Optimizing Antibiotic Use in California NICUs [OASCN]). The study found that pre-OASCN, 24% of respondents believed there was "a lot of" or "some" inappropriate prescribing, often driven by fear of a bad outcome or hesitation to change existing practices. Clinicians reported statistically significant increases in AS importance, perceived AS activity, and more openness to change after OASCN.
AHRQ-funded; HS026168.
Citation: Qureshi N, Kroger J, Zangwill KM .
Changes in perceptions of antibiotic stewardship among neonatal intensive care unit providers over the course of a learning collaborative: a prospective, multisite, mixed-methods evaluation.
J Perinatol 2024 Jan; 44(1):62-70. doi: 10.1038/s41372-023-01823-0..
Keywords: Antibiotics, Antimicrobial Stewardship, Newborns/Infants, Intensive Care Unit (ICU), Critical Care
Flannery DD, Zevallos Barboza A, Mukhopadhyay S
Antibiotic use among infants admitted to neonatal intensive care units.
The purpose of this cross-sectional study was to examine antibiotic exposure, days of therapy, types of antibiotics, and changes in use patterns among newborns in neonatal intensive care units (NICUs) across the U.S. Data for almost 1.4 million infants were taken from the Premier Healthcare Database. The most common antibiotics prescribed during the study period were ampicillin, gentamicin, vancomycin, and cefotaxime. Antibiotic use declined substantially over time, primarily because of reductions in ampicillin and gentamicin. The authors noted that these findings probably reflect the penetration of national calls for neonatal antibiotic stewardship efforts and refined early-onset infection risk-assessment strategies; shortage and subsequent discontinuation of cefotaxime may have played a role in the sharp decline in its use and the related increase in ceftazidime use.
AHRQ-funded; HS027468.
Citation: Flannery DD, Zevallos Barboza A, Mukhopadhyay S .
Antibiotic use among infants admitted to neonatal intensive care units.
JAMA Pediatr 2023 Dec; 177(12):1354-56. doi: 10.1001/jamapediatrics.2023.3664..
Keywords: Newborns/Infants, Antibiotics, Medication, Intensive Care Unit (ICU), Critical Care
Sullivan BA, Panda A, Wallman-Stokes A
Antibiotic spectrum index: a new tool comparing antibiotic use in three NICUs.
This study looked at a new tool called the antibiotic spectrum index (ASI) which quantifies antibiotic exposure by relative antimicrobial activity, adding information to exposure measured by days of therapy (DOT). This index was tested with very low-birth-weight infants (VLBW, <1500g) in 3 level-4 NICUs for 2 years at 2 sites and for 1 year at a third site. The authors calculated the ASI per antibiotic days and DOT per patient days for all admitted VLBW infants <32 weeks gestational age. The site with the highest DOT per patient days was found to have the lowest ASI per antibiotic days and the site with the highest mortality and infection rates were found to have the highest ASI per antibiotic days. Antibiotic utilization varied by center.
AHRQ-funded; HS026742.
Citation: Sullivan BA, Panda A, Wallman-Stokes A .
Antibiotic spectrum index: a new tool comparing antibiotic use in three NICUs.
Infect Control Hosp Epidemiol 2022 Nov;43(11):1553-57. doi: 10.1017/ice.2021.467..
Keywords: Antibiotics, Medication, Newborns/Infants, Intensive Care Unit (ICU), Critical Care, Antimicrobial Stewardship
Flannery DD, Passarella M, Mukhopadhyay S
Early childhood antibiotic utilization for infants discharged from the neonatal intensive care unit.
The purpose of this retrospective observational study was to determine antibiotic use for Neonatal Intensive Care Unit (NICU) Infants in the first 3 years after birth hospital discharge. Using data for 667,541 newborns discharged from 2007-2011 from Medicaid Analytic Extract, the researchers assessed the relationships between NICU admission and antibiotic prescription. The study reported that 596,999 infants received one or more antibiotics, with a media of 4 prescriptions across 3 person-years. NICU infants (N = 81 314) received more antibiotic prescriptions compared to non-NICU infants. The study concluded that compared to non-NICU infants, antibiotic utilization in early childhood was higher among infants discharged from NICUs.
AHRQ-funded; HS027468.
Citation: Flannery DD, Passarella M, Mukhopadhyay S .
Early childhood antibiotic utilization for infants discharged from the neonatal intensive care unit.
J Perinatol 2022 Jul;42(7):953-58. doi: 10.1038/s41372-022-01380-y..
Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Antibiotics, Medication
Flannery DD, Puopolo KM, Hansen NI
Antimicrobial susceptibility profiles among neonatal early-onset sepsis pathogens.
This retrospective review examined antimicrobial susceptibility of infants ≥22 weeks' gestation who were cared for in Neonatal Research Network centers April 2015-March 2017. Nonsusceptibility was defined as intermediate or resistant on treatment results. The authors identified 239 pathogens (235 bacteria, 4 fungi) in 235 EOS cases among 217,480 live-born infants. Antimicrobial susceptibility data was available for 79.1% of isolates. All 81 Gram-positive isolates with ampicillin and gentamicin were susceptible in vitro. Among Gram-negative isolates with ampicillin and gentamicin susceptibility data, 76.6% isolates were nonsusceptible to ampicillin, 8.5% nonsusceptible to gentamicin, and 7.3% isolates were nonsusceptible to both. The authors estimated that overall 8% of EOS cases were caused by isolates nonsceptible to ampicillin and gentamicin and were most likely to occur among preterm, very-low birth weight infants.
AHRQ-funded; HS027468.
Citation: Flannery DD, Puopolo KM, Hansen NI .
Antimicrobial susceptibility profiles among neonatal early-onset sepsis pathogens.
Pediatr Infect Dis J 2022 Mar;41(3):263-71. doi: 10.1097/inf.0000000000003380..
Keywords: Newborns/Infants, Sepsis, Antibiotics, Medication
Flannery DD, Mukhopadhyay S, Morales KH
Delivery characteristics and the risk of early-onset neonatal sepsis.
This retrospective cohort study identified term and preterm infants at lowest risk of culture-confirmed early-onset sepsis (EOS) using delivery characteristics and also determined antibiotic use among them. The study cohort included term and preterm infants born 2009 to 2014 with blood culture with or without cerebrospinal fluid culture obtained ≤72 hours after birth. Low EOS risk criteria included: cesarean delivery, without labor or membrane rupture before delivery, and no antepartum concern for intraamniotic infection or nonreassuring fetal status. Among 53,575 births, 7549 (14.1%) were evaluated and 41 (0.5%) of those infants had EOS. For 1121 evaluated infants there were low-risk delivery characteristics and none had EOS. Duration of antibiotics administered to infants born with and without low-risk characteristics was not different.
AHRQ-funded; HS027468.
Citation: Flannery DD, Mukhopadhyay S, Morales KH .
Delivery characteristics and the risk of early-onset neonatal sepsis.
Pediatrics 2022 Feb;149(2). doi: 10.1542/peds.2021-052900..
Keywords: Newborns/Infants, Sepsis, Risk, Labor and Delivery, Antibiotics, Medication
Flannery DD, Akinboyo IC, Mukhopadhyay S
Antibiotic susceptibility of Escherichia coli among infants admitted to neonatal intensive care units across the US From 2009 to 2017.
Investigators assessed the epidemiologic characteristics and antibiotic susceptibility patterns of E coli in infants admitted to neonatal intensive care units in the US over time. Using the Premier Health Database, they found nonsusceptibility to commonly administered antibiotics in substantial proportions of neonatal E coli isolates, with no significant change from 2009 to 2017. They suggested that their findings may inform empirical antibiotic choices for newborn infants.
AHRQ-funded; HS027468.
Citation: Flannery DD, Akinboyo IC, Mukhopadhyay S .
Antibiotic susceptibility of Escherichia coli among infants admitted to neonatal intensive care units across the US From 2009 to 2017.
JAMA Pediatr 2021 Feb;175(2):168-75. doi: 10.1001/jamapediatrics.2020.4719..
Keywords: Newborns/Infants, Antibiotics, Medication, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Infectious Diseases
Abreo A, Wu P, Donovan BM
Infant respiratory syncytial virus bronchiolitis and subsequent risk of pneumonia, otitis media, and antibiotic utilization.
This study looked at infant respiratory syncytial virus (RSV) bronchiolitis and its association with increased odds of pneumonia, otitis media, and antibiotic utilization in infants 7-12 months. The data suggested the potential value of future RSV vaccination programs on subsequent respiratory health.
AHRQ-funded; HS026395.
Citation: Abreo A, Wu P, Donovan BM .
Infant respiratory syncytial virus bronchiolitis and subsequent risk of pneumonia, otitis media, and antibiotic utilization.
Clin Infect Dis 2020 Jun 24;71(1):211-14. doi: 10.1093/cid/ciz1033..
Keywords: Newborns/Infants, Antibiotics, Medication, Respiratory Conditions, Pneumonia
Donovan BM, Abreo A, Ding T
Dose, timing, and type of infant antibiotic use and the risk of childhood asthma.
This study examined the association between dose, timing and type of infant antibiotic use and the risk of childhood asthma. The study examined a cohort of 152,622 children enrolled in the Tennessee Medicaid Program. At least 79% had at least one antibiotic prescription fill during infancy. There was a 20% increase in odds of childhood asthma for each additional antibiotic filled. There was no significant association between timing, formulation, anaerobic coverage and class of antibiotics and childhood asthma. However, broad spectrum antibiotic fills increased the odds of development of childhood asthma compared to narrow spectrum only fills.
AHRQ-funded; HS018454.
Citation: Donovan BM, Abreo A, Ding T .
Dose, timing, and type of infant antibiotic use and the risk of childhood asthma.
Clin Infect Dis 2020 Apr 10;70(8):1658-65. doi: 10.1093/cid/ciz448..
Keywords: Newborns/Infants, Children/Adolescents, Antibiotics, Medication, Asthma, Respiratory Conditions, Risk, Chronic Conditions
Desai S, Aronson PL, Shabanova V
Parenteral antibiotic therapy duration in young infants with bacteremic urinary tract infections.
This study compared rates of recurring bacteremic urinary tract infections (UTIs) among hospitalized infants who received parenteral antibiotics 7 days or less compared with infants who received long-term treatment defined as greater than 7 days. Among 115 infants with bactermic UTI, half received short-course parenteral antibiotics and no difference in 30-day UTI recurrence was found.
AHRQ-funded; HS026006.
Citation: Desai S, Aronson PL, Shabanova V .
Parenteral antibiotic therapy duration in young infants with bacteremic urinary tract infections.
Pediatrics 2019 Sep;144(3). doi: 10.1542/peds.2018-3844..
Keywords: Newborns/Infants, Antibiotics, Urinary Tract Infection (UTI), Medication, Inpatient Care, Hospitalization, Outcomes, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice
Wang HH, Kurtz M, Logvinenko T
Why does prevention of recurrent urinary tract infection not result in less renal scarring? A deeper dive into the RIVUR trial.
The RIVUR (Randomized Intervention for Children with Vesicoureteral Reflux) trial reported that antibiotic prophylaxis reduced recurrent urinary tract infection but antibiotic prophylaxis was not associated with decreased new renal scarring. However, the original reports did not assess the relationship among recurrent urinary tract infection, new renal scarring and antibiotic prophylaxis in detail. Therefore, this study investigated the relationship among these issues.
AHRQ-funded; HS000063.
Citation: Wang HH, Kurtz M, Logvinenko T .
Why does prevention of recurrent urinary tract infection not result in less renal scarring? A deeper dive into the RIVUR trial.
J Urol 2019 Aug;202(2):400-05. doi: 10.1097/ju.0000000000000292..
Keywords: Newborns/Infants, Urinary Tract Infection (UTI), Antibiotics, Medication, Prevention
Varda BK, Finkelstein JB, Wang HH
The association between continuous antibiotic prophylaxis and UTI from birth until initial postnatal imaging evaluation among newborns with antenatal hydronephrosis.
This study examined whether the routine use of continuous antibiotic prophylaxis (CAP) before initial postnatal imaging is effective to prevent urinary tract infection (UTI) in infants with a history of antenatal urinary tract dilation (AUTD). A single-institution, retrospective cohort study of infants with a history of AUTD was conducted. A random sample of 500 infants was selected with six excluded for other congenital anomalies. Of the 494 remaining, 157 (32%) received CAP. There was no difference found in UTI incidence among those treated with CAP and those who were not.
AHRQ-funded; HS000063.
Citation: Varda BK, Finkelstein JB, Wang HH .
The association between continuous antibiotic prophylaxis and UTI from birth until initial postnatal imaging evaluation among newborns with antenatal hydronephrosis.
J Pediatr Urol 2018 Dec;14(6):539.e1-39.e6. doi: 10.1016/j.jpurol.2018.04.022..
Keywords: Antibiotics, Antimicrobial Stewardship, Urinary Tract Infection (UTI), Newborns/Infants, Imaging, Medication, Prevention