National Healthcare Safety Network 2018 Baseline Neonatal Standardized Antimicrobial Administration Ratios

Area of Science:

• Neonatal infections
• Antimicrobial stewardship
• Healthcare quality metrics

Background:

• Neonatal infections present unique challenges in microbiology, clinical presentation, and treatment compared to adult and pediatric populations.
• The Centers for Disease Control and Prevention (CDC) introduced neonatal-specific Standardized Antimicrobial Administration Ratios (SAARs) in 2019.
• SAARs are risk-adjusted metrics for antimicrobial use surveillance within hospital antibiotic stewardship programs (ASPs).

Purpose of the Study:

• To develop and implement neonatal-specific Standardized Antimicrobial Administration Ratios (SAARs).
• To provide hospitals with tools for assessing antimicrobial agent use in neonatal populations.
• To support antibiotic stewardship programs (ASPs) in evaluating and improving prescribing practices.

Main Methods:

• Collaboration between the CDC and the Vermont Oxford Network to define eligible locations and SAAR agent categories.
• Implementation of neonatal-specific NHSN Annual Hospital Survey questions for data collection.
• Development of SAAR predictive models using 2018 data from eligible neonatal units reported to NHSN.

Main Results:

• Baseline neonatal SAAR models were established for 7 antimicrobial agent categories.
• Data from 324 neonatal units in 304 hospitals were used for the 2018 baseline.
• Predicted antimicrobial days (SAAR denominator) were calculated for various levels of neonatal special care nurseries and NICUs.

Conclusions:

• The National Healthcare Safety Network's (NHSN) neonatal SAARs enable hospitals to compare their antimicrobial use against a national baseline.
• These metrics help identify facilities with significantly higher or lower antimicrobial agent use rates.
• SAAR values can prompt investigations into prescribing patterns and inform targeted ASP interventions.