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Title:Antibiotic stewardship in premature infants : a systematic review
Authors:ID Rajar, Polona (Author)
ID Saugstad, Ola Didrik (Author)
ID Berild, Dag (Author)
ID Dutta, Anirban (Author)
ID Greisen, Gorm (Author)
ID Lausten-Thomsen, Ulrik (Author), et al.
Files:.pdf PDF - Presentation file, download (534,36 KB)
MD5: 2CAEB425FC0CB084EAC82CC802C70A5C
 
URL URL - Source URL, visit https://doi.org/10.1159/000511710
 
Language:English
Typology:1.02 - Review Article
Organization:Logo UKC LJ - Ljubljana University Medical Centre
Abstract:Introduction: Antibiotic treatment in premature infants is often empirically prescribed, and practice varies widely among otherwise comparable neonatal intensive care units. Unnecessary and prolonged antibiotic treatment is documented in numerous studies. Recent research shows serious side effects and suggests long-term adverse health effects in prematurely born infants exposed to antibiotics in early life. One preventive measure to reduce unnecessary antibiotic exposure is implementation of antibiotic stewardship programs. Our objective was to review the literature on implemented antibiotic stewardship programs including premature infants with gestational age ≤34 weeks. Methods: Six academic databases (PubMed [Medline], McMaster PLUS, Cochrane Database of Systematic Reviews, UpToDate, Cochrane Central Register of Controlled Trials, and National Institute for Health and Care Excellence) were systematically searched. PRISMA guidelines were applied. Results: The search retrieved 1,212 titles of which 12 fitted inclusion criteria (11 observational studies and 1 randomized clinical trial). Included articles were critically appraised. We grouped the articles according to common area of implemented stewardship actions: (1) focus on reducing initiation of antibiotic therapy, (2) focus on shortening duration of antibiotic therapy, (3) various organizational stewardship implementations. The heterogeneity of cohort composition, of implemented actions and of outcome measures made meta-analysis inappropriate. We provide an overview of the reduction in antibiotic use achieved. Conclusion: Antibiotic stewardship programs can be effective for premature newborns especially when multifactorial and tailored to this population, focusing on reducing initiation or on shortening the duration of antibiotic therapy. Programs without specific measures were less effective.
Keywords:antibiotic resistance, antibiotic stewardship, premature infant
Publication status:Published
Publication version:Version of Record
Year of publishing:2021
Number of pages:str. 673–686
Numbering:Vol. 117, issue 6
PID:20.500.12556/DiRROS-27791 New window
UDC:61
ISSN on article:1661-7819
DOI:10.1159/000511710 New window
COBISS.SI-ID:256512003 New window
Note:Nasl. z nasl. zaslona; Opis vira z dne 10. 11. 2025;
Publication date in DiRROS:25.02.2026
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Downloads:60
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Record is a part of a journal

Title:Neonatology
Shortened title:Neonatology
Publisher:S. Karger
ISSN:1661-7819
COBISS.SI-ID:3396372 New window

Document is financed by a project

Funder:Other - Other funder or multiple funders
Funding programme:Norwegian Research Council
Project number:273833
Name:Born in the twilight of antibiotics: Implications of antibiotic use to the preterm infant respiratory microbiome and resistome development

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License:CC BY-NC 4.0, Creative Commons Attribution-NonCommercial 4.0 International
Link:http://creativecommons.org/licenses/by-nc/4.0/
Description:A creative commons license that bans commercial use, but the users don’t have to license their derivative works on the same terms.

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