Related Experiment Video
Updated: Jul 12, 2025
Author Spotlight: Enhancing Understanding and Treatment Strategies with the NEC-on-a-Chip Model
Published on: July 28, 2023
A quality improvement initiative standardizing the antibiotic treatment and feeding practices in patients with
Zoya Mahmood1, Brighid O'Donnell1, Beverly S Brozanski1,2
1Department of Pediatrics, Division of Newborn Medicine, University of Pittsburgh School of Medicine, Pittsburgh, USA.
Insights
A new guideline for medical necrotizing enterocolitis (mNEC) in preterm infants significantly reduced antibiotic duration and time to full enteral feeding. This quality improvement initiative also decreased central line use and days, improving patient outcomes.
Area of Science:
- Neonatal Medicine
- Pediatric Surgery
- Quality Improvement in Healthcare
Background:
- Medical necrotizing enterocolitis (mNEC) is a serious condition in preterm infants.
- Standardizing care practices for mNEC can potentially improve outcomes and resource utilization.
Purpose of the Study:
- To evaluate the impact of a multidisciplinary guideline standardizing antibiotic duration and enteral feeding practices for infants with mNEC.
- To assess the effect of the guideline on key clinical outcomes.
Main Methods:
- A guideline was implemented for preterm infants with Bell Stage 2A mNEC and negative blood cultures.
- Antibiotic treatment was standardized to 7 days, with trophic feeds initiated 72 hours post-resolution of pneumatosis.
- Feed advancement protocols were standardized, with primary outcomes including antibiotic days and days to full feeds (120 cc/kg/day).
Main Results:
- Antibiotic duration decreased by 23%.
- Time to initiate trophic feeds and time to achieve full feeds decreased by 33% and 16%, respectively.
- Central line use dropped from 98% to 72% of infants, with a 59% reduction in central line days.
Conclusions:
- Implementation of the mNEC quality improvement (QI) package successfully reduced antibiotic duration.
- The QI initiative also decreased the time to full enteral feeds and significantly lowered central line use and associated days.
- Standardized guidelines for mNEC care can lead to improved clinical outcomes and resource management in neonatal intensive care units.
Objective:
Evaluate the impact of a multidisciplinary guideline standardizing antibiotic duration and enteral feeding practices following medical necrotizing enterocolitis (mNEC).
Study Design:
For preterm infants with Bell Stage 2 A mNEC and negative blood culture, antibiotic treatment was standardized to 7 days. Trophic feeds of unfortified human milk began 72 h after resolution of pneumatosis. Feeds were advanced by 20 cc/kg/day starting on the last day of antibiotics. Primary outcomes were antibiotic days and days to full feeds, defined as 120 cc/kg/day of enteral nutrition. Secondary outcomes included central line days and length of stay (LOS).
Results:
Antibiotic duration decreased 23%. Time to start trophic feeds and time to full feeds decreased 33 and 16% respectively. Central line use dropped (98 to 72% of infants) and central line days were reduced by 59%.
Conclusion:
Implementation of a mNEC QI package reduced antibiotic duration, time to full feeds, central line use and CL days.
More Related Videos
Related Concept Videos
01:26Enteral Nutrition I: Orogastric and Nasogastric Feeding
Orogastric (OG) and nasogastric (NG) feeding are two standard methods used for enteral nutrition. Enteral nutrition is often preferred over...
01:15Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...