TY - JOUR
T1 - Gastroschisis and low incidence of early-onset infection
T2 - a case for antimicrobial stewardship
AU - Children’s Hospitals Neonatal Consortium Gastroschisis Focus Group
AU - Riddle, Stefanie
AU - Agarwal, Nidhi
AU - Haberman, Beth
AU - Karpen, Heidi
AU - Miquel-Verges, Franscesca
AU - Nayak, Sujir Pritha
AU - Sullivan, Kevin
AU - Williams, Sadie
AU - Zaniletti, Isabella
AU - Jacobson, Elizabeth
N1 - Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Nature America, Inc.
PY - 2022/11
Y1 - 2022/11
N2 - Objective: Early onset infection (EOI) in gastroschisis is rare. Excess antibiotic exposure in neonates increases necrotizing enterocolitis and mortality. We evaluated antibiotic exposure and EOI in gastroschisis. Study design: Retrospective cohort analysis between 2010–2016 in the Children’s Hospital Neonatal Database. Included: Infants ≥32 weeks with gastroschisis admitted <48 h. Excluded: major anomalies or surgical intervention prior to admission. Primary outcome: EOI diagnosis (<72 h). Results: In 2021 patients with gastroschisis, median gestational age was 36 weeks (IQR 35, 37). 93.9% patients received empiric antibiotics after delivery, with median 7 days duration (IQR 3, 9). Only 13 patients (0.64%) had early positive blood culture. The rate of late onset blood stream infection (7.08%) was higher, and higher in complex (18%) than simple gastroschisis (4.8%, p < 0.001). Conclusion: Despite low incidence of EOI and risks of excess antibiotic exposure, neonates with gastroschisis are exposed to long courses of empiric antibiotics. These data should stimulate interinstitution work to improve antibiotic prescribing.
AB - Objective: Early onset infection (EOI) in gastroschisis is rare. Excess antibiotic exposure in neonates increases necrotizing enterocolitis and mortality. We evaluated antibiotic exposure and EOI in gastroschisis. Study design: Retrospective cohort analysis between 2010–2016 in the Children’s Hospital Neonatal Database. Included: Infants ≥32 weeks with gastroschisis admitted <48 h. Excluded: major anomalies or surgical intervention prior to admission. Primary outcome: EOI diagnosis (<72 h). Results: In 2021 patients with gastroschisis, median gestational age was 36 weeks (IQR 35, 37). 93.9% patients received empiric antibiotics after delivery, with median 7 days duration (IQR 3, 9). Only 13 patients (0.64%) had early positive blood culture. The rate of late onset blood stream infection (7.08%) was higher, and higher in complex (18%) than simple gastroschisis (4.8%, p < 0.001). Conclusion: Despite low incidence of EOI and risks of excess antibiotic exposure, neonates with gastroschisis are exposed to long courses of empiric antibiotics. These data should stimulate interinstitution work to improve antibiotic prescribing.
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U2 - 10.1038/s41372-022-01494-3
DO - 10.1038/s41372-022-01494-3
M3 - Article
C2 - 35987968
AN - SCOPUS:85136596744
SN - 0743-8346
VL - 42
SP - 1453
EP - 1457
JO - Journal of Perinatology
JF - Journal of Perinatology
IS - 11
ER -