Irfan Ahmad1, Muralidhar H Premkumar2, Amy B Hair2, Kevin M Sullivan3, Isabella Zaniletti4, Jotishna Sharma5, Sujir Pritha Nayak6, Kristina M Reber2, Michael Padula7, Beverly Brozanski8, Robert DiGeronimo9, Toby Debra Yanowitz10. 1. CHOC Children's Hospital, Orange, CA, USA. iahmad@choc.org. 2. Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA. 3. Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA. 4. Children's Hospital Association, Lenexa, KS, USA. 5. University of Missouri Kansas City School of Medicine, Kansas City, MO, USA. 6. University of Texas Southwestern, Dallas, TX, USA. 7. University of Pennsylvania, Children's Hospital of Philadelphia, Philadelphia, PA, USA. 8. Washington University School of Medicine, St. Louis, MO, USA. 9. University of Washington School of Medicine, Seattle, WA, USA. 10. University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Abstract
OBJECTIVES: To evaluate variability in antibiotic duration for necrotizing enterocolitis (NEC) and associated clinical outcomes. STUDY DESIGN: Five-hundred ninety-one infants with NEC (315 medical; 276 surgical) were included from 22 centers participating in Children's Hospitals Neonatal Consortium (CHNC). Multivariable analyses were used to determine predictors of variability in time to full feeds (TFF) and length of stay (LOS). RESULTS: Median (IQR) antibiotic duration was 12 (9, 17) days for medical and 17 (14, 21) days for surgical NEC. Wide variability in antibiotic use existed both within and among centers. Duration of antibiotic therapy was associated with longer TFF in both medical (OR 1.04, 95% CI [1.01, 1.05], p < 0.001) and surgical NEC (OR 1.02 [1, 1.03] p = 0.046); and with longer LOS in medical (OR 1.03 [1.02, 1.04], p < 0.001) and surgical NEC (OR 1.01 [1.01, 1.02], p = 0.002). CONCLUSION: Antibiotic duration for both medical and surgical NEC remains variable within and among high level NICUs.
OBJECTIVES: To evaluate variability in antibiotic duration for necrotizing enterocolitis (NEC) and associated clinical outcomes. STUDY DESIGN: Five-hundred ninety-one infants with NEC (315 medical; 276 surgical) were included from 22 centers participating in Children's Hospitals Neonatal Consortium (CHNC). Multivariable analyses were used to determine predictors of variability in time to full feeds (TFF) and length of stay (LOS). RESULTS: Median (IQR) antibiotic duration was 12 (9, 17) days for medical and 17 (14, 21) days for surgical NEC. Wide variability in antibiotic use existed both within and among centers. Duration of antibiotic therapy was associated with longer TFF in both medical (OR 1.04, 95% CI [1.01, 1.05], p < 0.001) and surgical NEC (OR 1.02 [1, 1.03] p = 0.046); and with longer LOS in medical (OR 1.03 [1.02, 1.04], p < 0.001) and surgical NEC (OR 1.01 [1.01, 1.02], p = 0.002). CONCLUSION: Antibiotic duration for both medical and surgical NEC remains variable within and among high level NICUs.