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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
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Surviving Sepsis in a Referral Neonatal Intensive Care Unit: Association between Time to Antibiotic Administration
Melissa Schmatz1, Lakshmi Srinivasan2, Robert W Grundmeier3
1Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA.
The Journal of Pediatrics
|October 13, 2019
Summary
Delayed antibiotic administration in neonatal intensive care units (NICUs) significantly increases mortality risk and prolongs cardiovascular dysfunction in infants with sepsis. Prompt treatment is crucial for better outcomes.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Clinical Pharmacology
Background:
- Sepsis is a critical condition in neonatal intensive care units (NICUs).
- The timing of antibiotic administration is a key factor in sepsis management.
- Understanding the impact of delayed treatment on neonatal outcomes is essential.
Purpose of the Study:
- To investigate the association between the time to antibiotic administration and mortality in NICU patients.
- To evaluate the relationship between delayed antibiotics and in-hospital outcomes, including ventilator-free and inotrope-free days.
Main Methods:
- Prospective evaluation of infants with suspected sepsis from September 2014 to February 2018.
- Sepsis defined by clinical concern, blood culture, and antibiotic administration.
- Linear models with generalized estimating equations used to analyze data.
Main Results:
- 128 episodes of culture-proven sepsis identified in 113 infants.
- Prolonged antibiotic administration time was linked to a 47% increased risk of 14-day and 30-day mortality.
- Delayed antibiotics were associated with fewer inotrope-free days.
Conclusions:
- Delayed antibiotic administration is an independent risk factor for mortality and prolonged cardiovascular dysfunction in infants with sepsis.
- Further research is needed to establish optimal antimicrobial timing for high-risk NICU populations.
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