Evidence map›Paper›PMID 31879765›Full record

ArticleJournal of the Pediatric Infectious Diseases Society2020

Hospital-level Antibiotic Use and Complexity of Care Among Neonates.

Prachi Singh, Martina A Steurer, Joseph B Cantey, Rachel L Wattier

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the Pediatric Infectious Diseases Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.9field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 14 citations in OpenAlex.

  1. Article
  2. Observational
  3. Article
  4. Article
  5. Prescribed daily-dose-based metrics of oral antibiotic use for hospitalized children in Japan.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

Prachi SinghDepartment of Infectious Diseases, University of California San Francisco Benioff Children's Hospital Oakland, Oakland, California, USA.
Martina A SteurerDepartment of Epidemiology and Biostatistics, Pediatrics and the California Preterm Birth Initiative, University of California San Francisco, San Francisco, California, USA.
Joseph B CanteyDepartment of Pediatrics, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA.
Rachel L WattierDepartment of Pediatrics, University of California San Francisco, San Francisco, California, USA.
University of California, San Francisco · USThe University of Texas Health Science Center at San Antonio · USUCSF Benioff Children's Hospital · US

Funding

Institutional Career Development Core (KL2)KL2TR002646 · NCATS · UNIVERSITY OF TEXAS HLTH SCIENCE CENTER · PI TSEVAT, JOEL · 2018 to 2022
$3.4M
NCATS NIH HHS KL2 TR002646
6 · The paper itself

Abstract

backgroundDespite increasing neonatal antibiotic stewardship efforts, understanding of interhospital variation in neonatal antibiotic use is limited.

methodsA retrospective cohort study was conducted among primarily academically affiliated hospitals participating in the Vizient Clinical Database/Resource Manager. Neonatal discharges were identified by admission age <1 month, excluding nonviable neonates and normal newborns. Hospitals with ≥100 neonatal discharges and complete data for January-December 2016 were included. Antibiotic use was measured in days of therapy per 1000 patient-days (DOT/1000 pd). A composite measure of neonatal care complexity (NCC; low, medium, high) was based on the volume of very low-birth-weight neonates and neonates undergoing surgical procedures, cardiac surgery, or extracorporeal membranous oxygenation.

resultsThe 118 included hospitals represented 184 716 neonatal discharges; 22 hospitals with low NCC, 56 with medium NCC, and 40 with high NCC. Mean antibiotic DOT/1000 pd was 363 (standard deviation [SD], 94) in high NCC hospitals, 243 (SD, 88) in medium NCC hospitals, and 184 (SD, 122) in low NCC hospitals. Increasing NCC was associated with higher antibiotic use, with an incidence rate ratio (IRR) of 1.95 (95% confidence interval [CI], 1.55 to 2.47) for high vs low NCC and IRR 1.31 (95% CI, 1.05 to 1.64) for medium vs low NCC. Increasing case mix index was associated with higher antibiotic use (IRR 1.86 per unit increase; 95% CI, 1.50 to 2.31).

conclusionsAggregate antibiotic use among hospitalized neonates varies based on care complexity. Substantial variation despite stratification by complexity suggests incomplete risk adjustment and/or avoidable variation in care.

Indexed as

Anti-Bacterial AgentsHospitalsHospitalizationHumansInfant, NewbornInfant, Very Low Birth WeightIntensive Care Units, NeonatalRetrospective StudiesAnti-Bacterial Agentsantibacterial agentsantimicrobial stewardshipnewborn infantrisk adjustment

Identifiers

PMID31879765
PMCPMC7974016
OpenAlexW2997637997

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.