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Timely Empiric Antimicrobials are associated with faster microbiologic clearance in Preterm neonates with late-onset bloodstream infections.
MedLine Citation:
PMID:  24990532     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIM: The impact of timely empiric antimicrobial therapy on neonates is unclear. Our aim was to examine rates of effective timely empiric antimicrobial therapy on preterm neonates, together with the associated outcomes.
METHODS: We performed a single-centre retrospective study of preterm infants (< 32 weeks' gestational age) with a late-onset (>72 hours of age) bloodstream infection (BSI). Empiric antimicrobial administration took place before the results of blood culture were available and its timing was determined by the electronic medical records.
RESULTS: Our cohort (n=105) was predominantly female (59%) and black (83%) with a mean (SD) gestational age of 27.4 (2.3) weeks and birth weight of 948 (335) grams. Effective empiric antimicrobials were initiated in 114 (69%) of 165 BSI episodes and a third of the BSIs without empiric antimicrobials were found to be fungal. Both antimicrobial timing (r=0.27, p=0.002) and fungal organism (r=0.35, p=0.0001) showed significant correlations and were independently associated with time to clearance. Neither variable was associated with survival or length of stay.
CONCLUSIONS: Two-thirds of preterm infants with late-onset BSIs received effective empiric antimicrobials. Timely empiric antimicrobials were associated with shorter time to microbiologic clearance. These data suggest the need for standardised guidelines and quality-improvement initiatives. This article is protected by copyright. All rights reserved.
Authors:
Girija Natarajan; Lea Monday; Terri Scheer; Mirjana Lulic-Botica
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-7-3
Journal Detail:
Title:  Acta paediatrica (Oslo, Norway : 1992)     Volume:  -     ISSN:  1651-2227     ISO Abbreviation:  Acta Paediatr.     Publication Date:  2014 Jul 
Date Detail:
Created Date:  2014-7-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9205968     Medline TA:  Acta Paediatr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
This article is protected by copyright. All rights reserved.
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