Pediatrics and Pediatric Surgery

Biography

Biography: Ke-Ni Niko Tien

Abstract

Antibiotics are the most commonly prescribed medications in the neonatal population throughout the country. Early antibiotic exposure is associated with asthma, allergic reaction, autoimmune disease and obesity later in childhood. The Vermont Oxford Network (VON) has partnered with the CDC to launch the “Choosing Antibiotics Wisely” quality improvement (QI) project in 2016. It involves the participation and collaboration of multidisciplinary teams nationwide, and the goal is to decrease the empiric antibiotic utility rate (AUR) for early onset sepsis (EOS). The American Academy Pediatrics (AAP) also supports Choosing Wisely^® campaign program to avoid empirical antibiotics use beyond 48 hours if blood cultures remain negative. Despite the recommendations from the CDC, AAP, and VON, the decision to initiate empirical antibiotic therapy is often governed by individual and institutional practices. At current practice, the CDC guideline is the framework most commonly used by the providers. However, the interpretation of the guideline varies among providers. Studies have shown that by implementing a recent published neonatal early-onset sepsis (EOS) calculator decreases the number of infants requiring antibiotic prophylaxis and reduces antibiotic exposure safely. The purpose of this quality improvement (QI) scholarly project is to implement the EOS calculator for infants ≥35 weeks gestational age (GA) with infection risk factors but well appearing in a newborn nursery (NBN) to reduce the need for laboratory evaluation and antibiotic exposure, as well as standardize the practice. The project is intended for quality improvement purpose to standardize the approach to the evaluation and treatment of infants at risk for early onset sepsis, to reduce the need for IV access as well as laboratory evaluation, and to decrease antibiotic exposure in this specific newborn nursery unit.