Appropriate and timely antibiotic administration for neonatal sepsis in Mesoamerica

被引:7
|
作者
Duber, Herbert C. [1 ,2 ]
Hartford, Emily A. [3 ]
Schaefer, Alexandra M. [1 ]
Johanns, Casey K. [1 ]
Colombara, Danny V. [1 ]
Iriarte, Emma [4 ]
Palmisano, Erin B. [1 ]
Rios-Zertuche, Diego [4 ]
Zuniga-Brenes, Paola [4 ]
Hernandez-Prado, Bernardo [1 ]
Mokdad, Ali H. [1 ]
机构
[1] Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA
[2] Univ Washington, Dept Emergency Med, Seattle, WA 98195 USA
[3] Univ Washington, Seattle Childrens Hosp, Dept Pediat, Seattle, WA 98195 USA
[4] Salud Mesoamer Initiat Interamer Dev Bank, Panama City, Panama
来源
BMJ GLOBAL HEALTH | 2018年 / 3卷 / 03期
关键词
GOAL-DIRECTED RESUSCITATION; NEWBORN SURVIVAL; MANAGEMENT; CARE; TRIAL;
D O I
10.1136/bmjgh-2017-000650
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Neonatal sepsis is a leading cause of mortality among children under-5 in Latin America. The Salud Mesoamerica Initiative (SMI), a multicountry results-based aid programme, was designed to improve maternal, newborn and child health in impoverished communities in Mesoamerica. This study examines the delivery of timely and appropriate antibiotics for neonatal sepsis among facilities participating in the SMI project. A multifaceted health facility survey was implemented at SMI inception and approximately 18 months later as a follow-up. A random sample of medical records from neonates diagnosed with sepsis was reviewed, and data regarding antibiotic administration were extracted. In this paper, we present the percentage of patients who received timely (within 2 hours) and appropriate antibiotics. Multilevel logistic regression was used to assess for potential facility-level determinants of timely and appropriate antibiotic treatment. Among 821 neonates diagnosed with sepsis in 63 facilities, 61.8% received an appropriate antibiotic regimen, most commonly ampicillin plus an aminoglycoside. Within 2 hours of presentation, 32.3% received any antibiotic and only 26.6% received an appropriate regimen within that time. Antibiotic availability improved over the course of the SMI project, increasing from 27.5% at baseline to 64.0% at follow-up, and it was highly correlated with timely and appropriate antibiotic administration (adjusted OR=5.36, 95% CI 2.85 to 10.08). However, we also found a decline in the percentage of neonates documented to have received appropriate antibiotics (74.4% vs 51.1%). Our study demonstrated early success of the SMI project through improvements in the availability of appropriate antibiotic regimens for neonatal sepsis. At the same time, overall rates of timely and appropriate antibiotic administration remain low, and the next phase of the initiative will need to address other barriers to the provision of life-saving antibiotic treatment for neonatal sepsis.
引用
收藏
页数:8
相关论文
共 50 条
  • [1] IMPACT OF AN ANTIBIOTIC-SPECIFIC SEPSIS BUNDLE ON APPROPRIATE AND TIMELY ANTIBIOTIC ADMINISTRATION FOR SEVERE SEPSIS IN THE EMERGENCY DEPARTMENT
    Kalich, Bethany A.
    Maguire, Jennifer M.
    Campbell-Bright, Stacy L.
    Mehrotra, Abhi
    Caffey, Tom
    Tulu, Zeynep
    Lin, Feng-Chang
    Carson, Shannon S.
    JOURNAL OF EMERGENCY MEDICINE, 2016, 50 (01): : 79 - 88
  • [2] Sepsis: impact of timely and appropriate empirical antibiotic therapy on mortality
    L Serpa-Pinto
    T Cardoso
    Critical Care, 18 (Suppl 1):
  • [3] Impact of antibiotic allergy labels on timely and appropriate antibiotics for sepsis in the emergency department
    Rush, Lily
    Rashidzada, Zohal
    Cairns, Kelly
    Roman, Cristina
    Bourne, Thomas
    Orosz, Judit
    Poole, Susan
    Lee, Sue J.
    Peel, Trisha
    JAC-ANTIMICROBIAL RESISTANCE, 2023, 5 (06):
  • [4] Facilitators and barriers of appropriate and timely initial fluid administration in sepsis: A qualitative study
    Kabil, Gladis
    Hatcher, Deborah
    Frost, Steven A.
    Shetty, Amith
    McNally, Stephen
    INTERNATIONAL EMERGENCY NURSING, 2023, 69
  • [5] Appropriate antibiotic therapy improves Ureaplasma sepsis outcome in the neonatal mouse
    Weisman, Leonard E.
    Leeming, Angela H.
    Kong, Lingkun
    PEDIATRIC RESEARCH, 2012, 72 (05) : 502 - 506
  • [6] Appropriate antibiotic therapy improves Ureaplasma sepsis outcome in the neonatal mouse
    Leonard E. Weisman
    Angela H. Leeming
    Lingkun Kong
    Pediatric Research, 2012, 72 : 502 - 506
  • [7] Evaluation of a Sepsis Care Bundle and Care Coordination for Timely Antibiotic Administration and Improving Hospital Outcomes
    Arain, E.
    Ye, C.
    Joyce, C.
    Zelisko, S.
    Afshar, M.
    Churpek, M. M.
    Gilbert, E. R.
    AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2018, 197
  • [8] Impact of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock in the emergency department
    Joo, Young Min
    Chae, Minjung Kathy
    Hwang, Sung Yeon
    Jin, Sang-Chan
    Lee, Tae Rim
    Cha, Won Chul
    Jo, Ik Joon
    Sim, Min Seob
    Song, Keun Jeong
    Jeong, Yeon Kwon
    Shin, Tae Gun
    CLINICAL AND EXPERIMENTAL EMERGENCY MEDICINE, 2014, 1 (01): : 35 - 40
  • [9] Improving Timely Antibiotic Administration in Pediatric Sepsis and Septic Shock in a Pediatric Intensive Care Unit
    Rillinger, Jay F.
    Hueschen, Leslie A.
    PEDIATRICS, 2021, 147 (03)
  • [10] Neonatal sepsis: The antibiotic crisis
    Isaacs, D
    INDIAN PEDIATRICS, 2005, 42 (01) : 9 - 13