Melissa Schmatz1, Lakshmi Srinivasan2, Robert W Grundmeier3, Okan U Elci4, Scott L Weiss5, Aaron J Masino6, Marissa Tremoglie1, Svetlana Ostapenko7, Mary Catherine Harris2. 1. Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA. 2. Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. 3. Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. 4. The Biostatistics and Data Management Core, The Children's Hospital of Philadelphia, Philadelphia, PA; Westat, Rockville, MD. 5. Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. 6. Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, PA; Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. 7. Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, PA.
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.
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.
Authors: Ayman Al-Eyadhy; Mohamad-Hani Temsah; Gamal M Hasan; Mohammed Almazyad; Ali A Alhaboob; Majed Alabdulhafid; Fahad Alsohime; Ahmed S Alzahrani; Abdullah M Alammari; Faisal S Abunohaiah; Nawaf F Alfawzan; Suhail S Alghamdi Journal: Saudi Med J Date: 2021-11 Impact factor: 1.422
Authors: Valentina Spaggiari; Erica Passini; Sara Crestani; Maria Federica Roversi; Luca Bedetti; Katia Rossi; Laura Lucaccioni; Cecilia Baraldi; Elisa Della Casa Muttini; Licia Lugli; Lorenzo Iughetti; Alberto Berardi Journal: Acta Biomed Date: 2022-07-01
Authors: Svetlana Ostapenko; Melissa Schmatz; Lakshmi Srinivasan; Okan U Elci; Scott L Weiss; Aaron J Masino; Marissa Tremoglie; Mary Catherine Harris; Robert W Grundmeier Journal: Data Brief Date: 2019-11-11