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Variability in vancomycin use in newborn intensive care units determined from data in an electronic medical record

Cody Arnold1, Reese Clark, Jaclyn Bosco

  • 1Department of Neonatology, Baylor University Medical Center, 3500 Gaston Ave., 3 Hoblitzelle, Dallas, TX 75246, USA. CodyA@BaylorHealth.edu

Infection Control and Hospital Epidemiology
|June 4, 2008
PubMed

Insights

Antibiotic prescribing for newborns varied widely across intensive care units. While vancomycin use was common, some units shifted to oxacillin or nafcillin over time.

Area of Science:

  • Neonatal Medicine
  • Infectious Diseases
  • Health Services Research

Background:

  • Antibiotic stewardship is crucial in neonatal intensive care units (NICUs).
  • Variations in antibiotic prescribing practices can impact patient outcomes and resistance.
  • Electronic medical records (EMRs) offer valuable data for studying antibiotic use.

Purpose of the Study:

  • To analyze the variation in vancomycin use among NICUs.
  • To investigate trends in the use of alternative antibiotics like oxacillin or nafcillin.
  • To highlight the utility of EMR data for antibiotic surveillance.

Main Methods:

  • Retrospective analysis of electronic medical record data.
  • Inclusion of data from 56 newborn intensive care units.
  • Examination of antibiotic prescribing patterns over a defined study period.

Main Results:

  • Significant variation in vancomycin treatment proportions (18%–70%) across 56 NICUs.
  • Initial infrequent use of oxacillin/nafcillin, becoming routine in 13% of NICUs by the study's end.
  • Demonstration of substantial heterogeneity in antibiotic selection for neonatal care.

Conclusions:

  • Wide variations in vancomycin use exist in NICUs, suggesting a need for standardized guidelines.
  • A shift towards oxacillin/nafcillin occurred in some NICUs, warranting further investigation.
  • EMR data are effective for monitoring and analyzing antibiotic utilization in neonatal populations.

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