Antibiotic Stewardship in Chorioamnionitis Exposed Neonates, A Quality Improvement Project

Jacquelyn Em Grev, Mallary Van Tol, Brooke Welker, Bette Schumacher, Lori Mulder, Andrea Dykstra, Laurie Richards

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Rates of neonatal early onset sepsis (EOS) in term infants have recently decreased. The 2018 AAP guidelines for the management of infants at risk for early onset sepsis allows for using a multivariate risk assessment to determine need for empiric antibiotics in infants 35 weeks or greater, including those exposed to chorioamnionitis. METHODS: A quality improvement (QI) project was undertaken to implement use of EOS calculator in chorioamnionitis exposed infants with an aim to safely decrease antibiotic exposure. Multiple Plan-Do-Study-Act (PDSA) cycles occurred to implement the change. Data regarding antibiotics, labs, length of stay and safety metrics were collected. RESULTS: Implementing the EOS calculator's use in chorioamnionitis exposed neonates decreased antibiotic exposure from 100% to 75%, and decreased average duration of antibiotics from 68 to 40 hours. Implementation decreased prolonged courses of antibiotics, lumbar punctures, length of stay and laboratory tests. No cases of early culture confirmed EOS were missed, and none occurred in this well appearing population. CONCLUSIONS: Quality improvement initiatives to implement evidence-based tools can safely and appropriately decrease antibiotic exposure in neonates.

Original languageEnglish (US)
Pages (from-to)300-303
Number of pages4
JournalSouth Dakota medicine : the journal of the South Dakota State Medical Association
Volume77
Issue number7
StatePublished - Jul 1 2024
Externally publishedYes

Bibliographical note

Publisher Copyright:
Copyright© South Dakota State Medical Association.

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