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. 2021 Nov 20;10(11):1422.
doi: 10.3390/antibiotics10111422.

Prescription of Aminoglycosides in 23 French Neonatal Intensive Care Units

Séverine Martin-Mons  1   2 , Béatrice Gouyon  2 , Séverine Lorrain  1 , Soumeth Abasse  3 , Cénéric Alexandre  4 , Guillaume Binson  5 , Roselyne Brat  6 , Laurence Caeymaex  7 , Yvan Couringa  8 , Cécile Desbruyeres  9 , Marine Dorsi-Di Meglio  10 , Guillaume Escourrou  11 , Florence Flamein  12 , Olivier Flechelles  13 , Olivier Girard  14 , Elsa Kermorvant-Duchemin  15   16 , Alexandre Lapillonne  16 , Catherine Lafon  17 , Massimo Di Maio  18 , Gaël Mazeiras  19 , Julien Mourdie  20 , Amélie Moussy-Durandy  21 , Anne-Sophie Pages  22 , Duksha Ramful  23 , Hasinirina Razafimahefa  24 , Jean-Marc Rosenthal  25 , Silvia Iacobelli  1   26 , Jean-Bernard Gouyon  1
Affiliations

Prescription of Aminoglycosides in 23 French Neonatal Intensive Care Units

Séverine Martin-Mons et al. Antibiotics (Basel). .

Abstract

Background: Aminoglycosides are the most prescribed antibiotics in neonatal intensive care units (NICU). Reducing exposure to antibiotics in the NICU is highly desirable, particularly through benchmarking methods. Methods: Description of aminoglycosides prescriptions in 23 French NICU using the same computerized system over a 4-year period (2017-2020). A benchmarking program of antibiotics prescription was associated. Results: The population included 53,818 patients. Exposition rates to gentamicin and amikacin were 31.7% (n = 17,049) and 9.1% (n = 4894), respectively. Among neonates exposed to gentamicin, 90.4% of gentamicin and 77.6% of amikacin treatments were started within the 1st week of life. Among neonates exposed to amikacin, 77.6% started amikacin within the 1st week. The average daily dose of gentamicin at first prescription increased over the study period from 3.9 in 2017 to 4.4 mg/kg/d in 2020 (p < 0.0001). Conversely, the corresponding amikacin daily doses decreased from 13.0 in 2017 to 12.3 mg/kg/d in 2020 (p = 0.001). The time interval between the first 2 doses of gentamicin was mainly distributed in 3 values during the first week of life: 49.4% at 24 h, 26.4% at 36 h, and 22.9% at 48 h. At first amikacin prescription, the time interval was distributed in 4 categories: 48% at 24 h, 4.1% at 30 h, 8.5% at 36 h, and 37.1% at 48 h. As compared to literature guidelines, the rates of overdose and underdose in gentamicin (1.5% and 2.7%) and amikacin (0.3% and 1.0%). They significantly decreased for gentamicin over the study period. In multivariate analysis, the factors significantly associated with GENT overdose were the year of admission, prematurity, length of stay, and duration of the treatment. Conclusion: This prescription strategy ensured a low rate of overdose and underdose, and some benefits of the benchmarking program is suggested.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Selection of aminoglycosides treated population.
Figure 2
Figure 2
Proportions of neonates with at least one gentamicin over-or under-dosed prescription in 23 neonatal intensive care units.
Figure 3
Figure 3
Proportions of neonates with at least one amikacin over-or-under-dosed prescription in 23 neonatal intensive care units.
See this image and copyright information in PMC

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