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Updated: Oct 12, 2025

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

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Factors associated with antibiotic administration delay among preterm infants with late-onset bloodstream infection

M Baczynski1, A Kharrat2, F Zhu3

  • 1Department of Respiratory Therapy, Mount Sinai Hospital, Toronto, ON, Canada.

The Journal of Hospital Infection
|November 20, 2021
PubMed

Insights

Timely antibiotic administration is crucial for reducing mortality in preterm infants with bloodstream infections. Delays are often caused by pre-antibiotic sample collection and difficulties with IV access or fluid boluses.

Area of Science:

  • Neonatal Medicine
  • Infectious Diseases
  • Pediatric Critical Care

Background:

  • Late-onset bloodstream infections (BSIs) pose a significant threat to preterm infants.
  • Early antibiotic administration is a critical, modifiable factor in reducing BSI-related mortality.
  • Identifying factors contributing to delayed antibiotic treatment is essential for improving outcomes.

Purpose of the Study:

  • To identify modifiable practice-related factors associated with delayed antibiotic administration in preterm infants with non-coagulase negative staphylococcus bloodstream infections.

Main Methods:

  • A cohort study was conducted involving 142 preterm infants diagnosed with non-coagulase negative staphylococcus bloodstream infections.
  • Data were collected from two tertiary neonatal intensive care units.
  • Factors associated with time to antibiotic administration were analyzed.

Main Results:

  • Delays in antibiotic administration were linked to the collection of cerebrospinal fluid or urine samples prior to treatment.
  • Difficulty in establishing peripheral intravenous (IV) access contributed to longer times to antibiotics.
  • Delayed administration of fluid boluses was also associated with increased time to antibiotic treatment.

Conclusions:

  • Pre-antibiotic diagnostic procedures, challenges with IV access, and fluid resuscitation timing are key factors delaying antibiotic administration.
  • Targeting these modifiable factors can help reduce treatment delays and improve survival rates for preterm infants with BSIs.

Keywords:
Antibiotic administration delayLate-onset bloodstream infectionNeonatal intensive care unitPractice-related factorsPreterm infantsQuality improvement

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