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Observational Study
. 2022 Jul;42(7):953-958.
doi: 10.1038/s41372-022-01380-y.

Early childhood antibiotic utilization for infants discharged from the neonatal intensive care unit

Dustin D Flannery  1   2   3 , Molly Passarella  4 , Sagori Mukhopadhyay  4   5   6 , Miren B Dhudasia  4   6 , Jeffrey S Gerber  5   6   7 , Scott A Lorch  4   5   6 , Sean Hennessy  8 , Karen M Puopolo  4   5   6
Affiliations
Observational Study

Early childhood antibiotic utilization for infants discharged from the neonatal intensive care unit

Dustin D Flannery et al. J Perinatol. 2022 Jul.

Abstract

Objective: To determine antibiotic utilization for NICU infants, as compared to non-NICU infants, in the first 3 years after birth hospital discharge.

Study design: Retrospective observational study using data from Medicaid Analytic Extract including 667 541 newborns discharged from 2007-2011. Associations between NICU admission and antibiotic prescription were assessed using regression models, adjusting for confounders, and stratified by gestational age and birth weight.

Results: 596 999 infants (89.4%) received ≥1 antibiotic, with a median of 4 prescriptions per 3 person-years (IQR 2-8). Prescribed antibiotics and associated indication were similar between groups. Compared to non-NICU infants (N = 586 227), NICU infants (N = 81 314) received more antibiotic prescriptions (adjusted incidence rate ratio 1.08, 95% confidence interval [CI] (1.08,1.08)). Similar results were observed in all NICU subgroups.

Conclusions: Antibiotic utilization in early childhood was higher among infants discharged from NICUs compared to non-NICU infants.

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Conflict of interest statement

DISCLOSURES

Portions of this study were presented as a platform presentation at the Pediatric Academic Societies 2021 annual meeting, which was held virtually. Otherwise, authors report no conflicts of interest, including no competing financial interests, in relation to the work described.

CONFLICT OF INTEREST

All authors report there are no competing financial interests in relation to the work described.

Figures

Figure:
Figure:
Antibiotic Prescription Timing Distribution Footnote: This forest plot shows the distribution of antibiotic prescription timing after discharge. NICU infants by gestational age category and non-NICU infant group are shown on the x-axis and the mean number of outpatient prescriptions after discharge on the y-axis. The error bars represent the 95% confidence intervals around the mean. There were differences in mean antibiotic use between groups for each 12-month comparison (all with P <0.001).
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