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Prevalence and Patterns of Antibiotic Administration in Neonates With Critical Congenital Heart Defects
Jessica A Davis1, Em Seiler, Rod Ghassemzadeh
1Author Affiliations: Department of Pediatrics, Division of General Academic Pediatrics (Davis and Martin), UMPC Children's Hospital of Pittsburgh (Davis, Seiler, Ghassemzadeh, Firek, Quigley, Kreutzer, Morowitz), Department of Critical Care Medicine (Ghassemzadeh, Baust, Quigley), Department of Pediatrics, Division of Cardiology (Kreutzer); Department of Health and Community Systems (Ren), and Department of Surgery (Morowitz), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Insights
Most neonates with critical congenital heart defects (CCHDs) received antibiotics, often not for infections. This highlights a need to understand and potentially reduce empiric antibiotic use in this vulnerable population.
Area of Science:
- Neonatal Cardiology
- Pediatric Infectious Diseases
- Clinical Pharmacology
Background:
- Limited data exists on empiric antibiotic use in neonates with critical congenital heart defects (CCHDs).
- Widespread antibiotic use is documented in other critically ill neonatal populations.
- Understanding antibiotic use patterns in CCHD neonates is crucial.
Purpose of the Study:
- To determine the prevalence of antibiotic treatment within the first 28 days of life in neonates with CCHDs.
- To describe the indications for antibiotic use in this cohort.
- To identify predictors of antibiotic use.
Main Methods:
- Retrospective analysis of electronic health records from a Pennsylvania pediatric hospital (2016-2020).
- Inclusion of 74 neonates admitted for cardiac surgery.
- Descriptive statistics and multivariable regression models were employed.
Main Results:
- 68% of neonates (50/74) received antibiotics for indications other than postoperative prophylaxis.
- Only 3% of neonates (2/74) had confirmed bacteremia.
- Antibiotic administration was prevalent in this CCHD cohort.
Conclusions:
- Empiric antibiotic administration is common in neonates with CCHDs.
- Further research is needed to understand the prevalence and consequences of empirical antibiotic use.
- Interventions to prevent antibiotic overuse in this population should be developed.
Background:
Although data exists demonstrating widespread antibiotic use across other critically ill neonatal populations, there are limited data regarding the frequency of empiric antibiotic use among neonates with critical congenital heart defects (CCHD). The purpose of this study is to describe prevalence of antibiotic treatment in the first 28 days of life in a cohort of neonates with CCHDs.
Methods:
A secondary analysis of retrospective electronic health record data of neonates admitted to a Pennsylvania pediatric hospital for cardiac surgery (2016-2020). Descriptive statistics were generated to show antibiotic treatment days and indications for use. Pearson Chi-Square and multivariable regression models were used to analyze predictors.
Results:
Seventy-four neonates were included. Fifty neonates (68%) received antibiotics for reasons other than postoperative prophylaxis. Two (3%) had confirmed bacteremia.
Conclusions:
Antibiotic administration was prevalent in this cohort. Future work should elucidate population prevalence of empirical antibiotic use, identify potential consequences, and design interventions to prevent overuse.
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