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

Journal of Perinatology volume 42, pages 953–958 (2022)Cite this article

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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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Fig. 1: Antibiotic prescription timing distribution.

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Data availability

MP had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

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Funding

DDF received grant funding unrelated to this study from the Agency for Healthcare Research and Quality (K08HS027468), the Children’s Hospital of Philadelphia, and from two research contracts from the Centers for Disease Control and Prevention. KMP received grant funding unrelated to this study from the National Institutes of Health, the Children’s Hospital of Philadelphia, and from two contracts with the Centers for Disease Control and Prevention. The funding organizations had no role in the design or conduct of the study; collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscripts; or decision to submit the manuscript for publication.

Author information

Authors and Affiliations

  1. Division of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Dustin D. Flannery, Molly Passarella, Sagori Mukhopadhyay, Miren B. Dhudasia, Scott A. Lorch & Karen M. Puopolo

  2. Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA

    Dustin D. Flannery, Sagori Mukhopadhyay, Jeffrey S. Gerber, Scott A. Lorch & Karen M. Puopolo

  3. Center for Pediatric Clinical Effectiveness, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Dustin D. Flannery, Sagori Mukhopadhyay, Miren B. Dhudasia, Jeffrey S. Gerber, Scott A. Lorch & Karen M. Puopolo

  4. Division of Infectious Diseases, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Jeffrey S. Gerber

  5. Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA

    Sean Hennessy

Authors
  1. Dustin D. Flannery
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  2. Molly Passarella
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  8. Karen M. Puopolo
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Contributions

DDF conceptualized the study, analyzed the data, drafted the initial manuscript, and reviewed and revised the manuscript. MP contributed to the study design, analyzed the data, and reviewed and revised the manuscript. MBD, SM, JSG, SAL, SH, and KMP contributed to the study design, and reviewed and revised the manuscript. All authors approved the final manuscript for submission.

Corresponding author

Correspondence to Dustin D. Flannery.

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The authors declare no competing interests.

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Flannery, D.D., Passarella, M., Mukhopadhyay, S. et al. Early childhood antibiotic utilization for infants discharged from the neonatal intensive care unit. J Perinatol 42, 953–958 (2022). https://doi.org/10.1038/s41372-022-01380-y

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