Antimicrobial policies in the neonatal units of the United Kingdom and Republic of Ireland
Objectives To review antibiotic and antifungal policies in British and Irish neonatal units (NNUs). Methods A telephone survey was performed regarding empirical antimicrobial guidelines of NNUs in the UK and Republic of Ireland. Results The response rate was 91% (202 of 222 NNUs). The guidelines fro...
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| Veröffentlicht in: | Journal of antimicrobial chemotherapy 2008-03, Vol.61 (3), p.743-745 |
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| container_title | Journal of antimicrobial chemotherapy |
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| creator | Fernando, Andrew Michael Russell Heath, Paul Trafford Menson, Esse Natasha |
| description | Objectives To review antibiotic and antifungal policies in British and Irish neonatal units (NNUs). Methods A telephone survey was performed regarding empirical antimicrobial guidelines of NNUs in the UK and Republic of Ireland. Results The response rate was 91% (202 of 222 NNUs). The guidelines from all responding units covered group B Streptococcus and Escherichia coli, the most common causes of neonatal septicaemia and meningitis. However, 19% did not cover Listeria, the cause of meningitis in 5% to 7% of cases in England and Wales. Second-line recommendations varied greatly between units, with widespread use of broad-spectrum agents. Fungal prophylaxis and treatment guidelines were generally rudimentary. Conclusions Empirical antimicrobial recommendations on many NNUs include broad-spectrum antibiotics without ensuring universal coverage of important pathogens. We raise concerns about the selection pressures exerted for resistant pathogens and invasive fungal disease, especially as few units specify fungal prophylaxis or treatment guidance. Development of rational guidelines for the UK and Irish neonatal units might help to optimize treatment while minimizing overuse of broad-spectrum agents. |
| doi_str_mv | 10.1093/jac/dkm543 |
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Methods A telephone survey was performed regarding empirical antimicrobial guidelines of NNUs in the UK and Republic of Ireland. Results The response rate was 91% (202 of 222 NNUs). The guidelines from all responding units covered group B Streptococcus and Escherichia coli, the most common causes of neonatal septicaemia and meningitis. However, 19% did not cover Listeria, the cause of meningitis in 5% to 7% of cases in England and Wales. Second-line recommendations varied greatly between units, with widespread use of broad-spectrum agents. Fungal prophylaxis and treatment guidelines were generally rudimentary. Conclusions Empirical antimicrobial recommendations on many NNUs include broad-spectrum antibiotics without ensuring universal coverage of important pathogens. We raise concerns about the selection pressures exerted for resistant pathogens and invasive fungal disease, especially as few units specify fungal prophylaxis or treatment guidance. Development of rational guidelines for the UK and Irish neonatal units might help to optimize treatment while minimizing overuse of broad-spectrum agents.</description><identifier>ISSN: 0305-7453</identifier><identifier>EISSN: 1460-2091</identifier><identifier>DOI: 10.1093/jac/dkm543</identifier><identifier>PMID: 18238883</identifier><identifier>CODEN: JACHDX</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Anti-Infective Agents - therapeutic use ; Antibiotics ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; antimicrobial agents ; Bacteria ; Biological and medical sciences ; Chemotherapy ; Data Collection - methods ; Drug Resistance, Microbial ; Escherichia coli ; Fungal infections ; guidelines ; Health Policy ; Humans ; Infant, Newborn ; Infections ; Intensive Care Units, Neonatal - standards ; Ireland - epidemiology ; Listeria ; Medical sciences ; Neonatal care ; neonatal infection ; Pharmacology. 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For Permissions, please e-mail: journals.permissions@oxfordjournals.org</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c477t-10fe45f1ab0d61805a1540b1fabdc5ff7acf3c61de061e016ce36a64bd9331c43</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1578,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20162966$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18238883$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fernando, Andrew Michael Russell</creatorcontrib><creatorcontrib>Heath, Paul Trafford</creatorcontrib><creatorcontrib>Menson, Esse Natasha</creatorcontrib><title>Antimicrobial policies in the neonatal units of the United Kingdom and Republic of Ireland</title><title>Journal of antimicrobial chemotherapy</title><addtitle>J Antimicrob Chemother</addtitle><description>Objectives To review antibiotic and antifungal policies in British and Irish neonatal units (NNUs). Methods A telephone survey was performed regarding empirical antimicrobial guidelines of NNUs in the UK and Republic of Ireland. Results The response rate was 91% (202 of 222 NNUs). The guidelines from all responding units covered group B Streptococcus and Escherichia coli, the most common causes of neonatal septicaemia and meningitis. However, 19% did not cover Listeria, the cause of meningitis in 5% to 7% of cases in England and Wales. Second-line recommendations varied greatly between units, with widespread use of broad-spectrum agents. Fungal prophylaxis and treatment guidelines were generally rudimentary. Conclusions Empirical antimicrobial recommendations on many NNUs include broad-spectrum antibiotics without ensuring universal coverage of important pathogens. We raise concerns about the selection pressures exerted for resistant pathogens and invasive fungal disease, especially as few units specify fungal prophylaxis or treatment guidance. Development of rational guidelines for the UK and Irish neonatal units might help to optimize treatment while minimizing overuse of broad-spectrum agents.</description><subject>Anti-Infective Agents - therapeutic use</subject><subject>Antibiotics</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>antimicrobial agents</subject><subject>Bacteria</subject><subject>Biological and medical sciences</subject><subject>Chemotherapy</subject><subject>Data Collection - methods</subject><subject>Drug Resistance, Microbial</subject><subject>Escherichia coli</subject><subject>Fungal infections</subject><subject>guidelines</subject><subject>Health Policy</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Infections</subject><subject>Intensive Care Units, Neonatal - standards</subject><subject>Ireland - epidemiology</subject><subject>Listeria</subject><subject>Medical sciences</subject><subject>Neonatal care</subject><subject>neonatal infection</subject><subject>Pharmacology. Drug treatments</subject><subject>Practice Guidelines as Topic - standards</subject><subject>Streptococcus</subject><subject>United Kingdom - epidemiology</subject><issn>0305-7453</issn><issn>1460-2091</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0c1LHDEUAPBQlLq1vfQPkEFoD4XRvMnHzByXpa1SpVAUxEvI5KNmnUnGZAba_77Z7qLgQU8hL7-85L2H0EfAJ4BbcrqW6lTfD4ySN2gBlOOywi3soQUmmJU1ZeQAvUtpjTHmjDdv0QE0FWmahizQ7dJPbnAqhs7JvhhD75QzqXC-mO5M4U3wcsoHs3dTKoL9H73OG6OLH87_1mEopNfFLzPOXb67IefR9Dn2Hu1b2SfzYbceoutvX69WZ-XFz-_nq-VFqWhdTyVgayizIDusOTSYSWAUd2BlpxWztpbKEsVBG8zBYODKEC457XRLCChKDtHnbd4xhofZpEkMLinT5z-YMCdR5zY0jJBXIbSsYrTaZDx-Btdhjj4XISqoecNawjL6skW5dylFY8UY3SDjXwFYbOYi8lzEdi4ZH-0yzt1g9BPdDSKDTzsgk5K9jdIrlx5dleuuWs6fXJjHlx8st86lyfx5lDLeC16Tmomzm1uxugJS8csb0ZJ_0vKxPQ</recordid><startdate>20080301</startdate><enddate>20080301</enddate><creator>Fernando, Andrew Michael Russell</creator><creator>Heath, Paul Trafford</creator><creator>Menson, Esse Natasha</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7QO</scope><scope>7T7</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20080301</creationdate><title>Antimicrobial policies in the neonatal units of the United Kingdom and Republic of Ireland</title><author>Fernando, Andrew Michael Russell ; Heath, Paul Trafford ; Menson, Esse Natasha</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c477t-10fe45f1ab0d61805a1540b1fabdc5ff7acf3c61de061e016ce36a64bd9331c43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Anti-Infective Agents - therapeutic use</topic><topic>Antibiotics</topic><topic>Antibiotics. Antiinfectious agents. Antiparasitic agents</topic><topic>antimicrobial agents</topic><topic>Bacteria</topic><topic>Biological and medical sciences</topic><topic>Chemotherapy</topic><topic>Data Collection - methods</topic><topic>Drug Resistance, Microbial</topic><topic>Escherichia coli</topic><topic>Fungal infections</topic><topic>guidelines</topic><topic>Health Policy</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Infections</topic><topic>Intensive Care Units, Neonatal - standards</topic><topic>Ireland - epidemiology</topic><topic>Listeria</topic><topic>Medical sciences</topic><topic>Neonatal care</topic><topic>neonatal infection</topic><topic>Pharmacology. Drug treatments</topic><topic>Practice Guidelines as Topic - standards</topic><topic>Streptococcus</topic><topic>United Kingdom - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fernando, Andrew Michael Russell</creatorcontrib><creatorcontrib>Heath, Paul Trafford</creatorcontrib><creatorcontrib>Menson, Esse Natasha</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of antimicrobial chemotherapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fernando, Andrew Michael Russell</au><au>Heath, Paul Trafford</au><au>Menson, Esse Natasha</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Antimicrobial policies in the neonatal units of the United Kingdom and Republic of Ireland</atitle><jtitle>Journal of antimicrobial chemotherapy</jtitle><addtitle>J Antimicrob Chemother</addtitle><date>2008-03-01</date><risdate>2008</risdate><volume>61</volume><issue>3</issue><spage>743</spage><epage>745</epage><pages>743-745</pages><issn>0305-7453</issn><eissn>1460-2091</eissn><coden>JACHDX</coden><abstract>Objectives To review antibiotic and antifungal policies in British and Irish neonatal units (NNUs). Methods A telephone survey was performed regarding empirical antimicrobial guidelines of NNUs in the UK and Republic of Ireland. Results The response rate was 91% (202 of 222 NNUs). The guidelines from all responding units covered group B Streptococcus and Escherichia coli, the most common causes of neonatal septicaemia and meningitis. However, 19% did not cover Listeria, the cause of meningitis in 5% to 7% of cases in England and Wales. Second-line recommendations varied greatly between units, with widespread use of broad-spectrum agents. Fungal prophylaxis and treatment guidelines were generally rudimentary. Conclusions Empirical antimicrobial recommendations on many NNUs include broad-spectrum antibiotics without ensuring universal coverage of important pathogens. We raise concerns about the selection pressures exerted for resistant pathogens and invasive fungal disease, especially as few units specify fungal prophylaxis or treatment guidance. Development of rational guidelines for the UK and Irish neonatal units might help to optimize treatment while minimizing overuse of broad-spectrum agents.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>18238883</pmid><doi>10.1093/jac/dkm543</doi><tpages>3</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Anti-Infective Agents - therapeutic use Antibiotics Antibiotics. Antiinfectious agents. Antiparasitic agents antimicrobial agents Bacteria Biological and medical sciences Chemotherapy Data Collection - methods Drug Resistance, Microbial Escherichia coli Fungal infections guidelines Health Policy Humans Infant, Newborn Infections Intensive Care Units, Neonatal - standards Ireland - epidemiology Listeria Medical sciences Neonatal care neonatal infection Pharmacology. Drug treatments Practice Guidelines as Topic - standards Streptococcus United Kingdom - epidemiology |
| title | Antimicrobial policies in the neonatal units of the United Kingdom and Republic of Ireland |
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