Evidence map›Paper›PMID 32170951›Full record

Observational studyJournal of the Pediatric Infectious Diseases Society2021

Influence of Patient Characteristics on Antibiotic Use Rates Among Preterm Infants.

Dustin D Flannery, Sagori Mukhopadhyay, Erik A Jensen, Jeffrey S Gerber, Molly R Passarella, Kevin Dysart, Zubair H Aghai, Jay Greenspan, Karen M Puopolo

Open access · greenAbstract readObservational Study
In one paragraph

Observational study in Journal of the Pediatric Infectious Diseases Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.1field-weighted citation impact, top 21% 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

3 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Article
  3. 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

9 authors at 4 institutions in 1 country.

Dustin D FlanneryCenter for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Sagori MukhopadhyayCenter for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Erik A JensenCenter for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Jeffrey S GerberCenter for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Molly R PassarellaDivision of Neonatology, Children's Hospital of Philadelphia/University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Kevin DysartDivision of Neonatology, Children's Hospital of Philadelphia/University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Zubair H AghaiDivision of Neonatology, Nemours/Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Jay GreenspanDivision of Neonatology, Nemours/Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Karen M PuopoloCenter for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
University of Pennsylvania · USChildren's Hospital of Philadelphia · USThomas Jefferson University Hospital · USPhiladelphia University · US

Funding

Pediatric Hospital Epidemiology and Outcomes Research Training ProgramT32HD060550 · NICHD · CHILDREN'S HOSP OF PHILADELPHIA · PI Christopher Peter Bonafide, John Chris Feudtner · 2010 to 2026
$6.8M
Microbiome of the Airway and the Risk for Bronchopulmonary Dysplasia in the Lungs of Extreme Preterms: The MARBLE StudyK23HL136843 · NHLBI · CHILDREN'S HOSP OF PHILADELPHIA · PI JENSEN, ERIK ALLEN · 2018 to 2022
$819k
Incidence of atopy and childhood infections in uninfected term newborns with perinatal antibiotic exposureK23HD088753 · NICHD · CHILDREN'S HOSP OF PHILADELPHIA · PI MUKHOPADHYAY, SAGORI · 2017 to 2021
$790k
NHLBI NIH HHS K23 HL136843NICHD NIH HHS K23 HD088753NICHD NIH HHS T32 HD060550
6 · The paper itself

Abstract

backgroundThe antibiotic use rate (AUR) has emerged as a potential metric for neonatal antibiotic use, but reported center-level AURs are limited by differences in case mix. The objective of this study was to identify patient characteristics associated with AUR among a large cohort of preterm infants.

methodsRetrospective observational study using the Optum Neonatal Database, including infants born from January 1, 2010 through November 30, 2016 with gestational age 23-34 weeks admitted to neonatal units across the United States. Exposures were patient-level characteristics including length of stay, gestational age, sex, race/ethnicity, bacterial sepsis, necrotizing enterocolitis, and survival status. The primary outcome was AUR, defined as days with ≥ 1 systemic antibiotic administered divided by length of stay. Descriptive statistics, univariable comparative analyses, and generalized linear models were utilized.

resultsOf 17 910 eligible infants, 17 836 infants (99.6%) from 1090 centers were included. Median gestation was 32.9 (interquartile range [IQR], 30.3-34) weeks. Median length of stay was 25 (IQR, 15-46) days and varied by gestation. Overall median AUR was 0.13 (IQR, 0-0.26) and decreased over time. Gestational age, sex, and race/ethnicity were independently associated with AUR (P < .01). AUR and gestational age had an unexpected inverse parabolic relationship, which persisted when only surviving infants without bacterial sepsis or necrotizing enterocolitis were analyzed.

conclusionsNeonatal AURs are influenced by patient-level characteristics besides infection and survival status, including gestational age, sex, and race/ethnicity. Neonatal antibiotic use metrics that account for patient-level characteristics as well as morbidity case mix may allow for more accurate comparisons and better inform neonatal antibiotic stewardship efforts.

Indexed as

Antimicrobial StewardshipEnterocolitis, NecrotizingInfant, Premature, DiseasesAnti-Bacterial AgentsHumansInfantInfant, NewbornInfant, PrematureIntensive Care Units, NeonatalRetrospective StudiesUnited StatesAnti-Bacterial Agentsantibiotic stewardshipantibiotic use ratebenchmarkingneonatalprematurity

Identifiers

PMID32170951
PMCPMC7996645
OpenAlexW3011540288

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.