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. 2024 Apr;44(4):587-593.
doi: 10.1038/s41372-023-01797-z. Epub 2023 Oct 20.

A quality improvement initiative standardizing the antibiotic treatment and feeding practices in patients with medical necrotizing enterocolitis

Zoya Mahmood  1 , Brighid O'Donnell  1 , Beverly S Brozanski  1   2 , Kalyani Vats  1 , Jennifer Kloesz  1 , Laura E Jackson  1   3 , Jennifer Shenk  4 , Melinda Miller  4 , Mary Beth Pasqualicchio  5 , Haley Schmidt  6 , Abeer Azzuqa  1 , Toby Debra Yanowitz  7
Affiliations

A quality improvement initiative standardizing the antibiotic treatment and feeding practices in patients with medical necrotizing enterocolitis

Zoya Mahmood et al. J Perinatol. 2024 Apr.

Abstract

Objective: Evaluate the impact of a multidisciplinary guideline standardizing antibiotic duration and enteral feeding practices following medical necrotizing enterocolitis (mNEC).

Study design: For preterm infants with Bell Stage 2 A mNEC and negative blood culture, antibiotic treatment was standardized to 7 days. Trophic feeds of unfortified human milk began 72 h after resolution of pneumatosis. Feeds were advanced by 20 cc/kg/day starting on the last day of antibiotics. Primary outcomes were antibiotic days and days to full feeds, defined as 120 cc/kg/day of enteral nutrition. Secondary outcomes included central line days and length of stay (LOS).

Results: Antibiotic duration decreased 23%. Time to start trophic feeds and time to full feeds decreased 33 and 16% respectively. Central line use dropped (98 to 72% of infants) and central line days were reduced by 59%.

Conclusion: Implementation of a mNEC QI package reduced antibiotic duration, time to full feeds, central line use and CL days.

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References

    1. Battersby C, Santhalingam T, Costeloe K, Modi N. Incidence of neonatal necrotising enterocolitis in high-income countries: a systematic review. Arch Dis Child Fetal Neonatal Ed. 2018;103:F182–9. - DOI - PubMed
    1. Neu J, Walker WA. Necrotizing enterocolitis. N Engl J Med. 2011;364:255–64. - DOI - PubMed - PMC
    1. Terrin G, Scipione A, De Curtis M. Update in Pathogenesis and Prospective in Treatment of Necrotizing Enterocolitis. Biomed Res Int. 2014;2014:543765. https://doi.org/10.1155/2014/543765 . - DOI - PubMed - PMC
    1. Walsh MC, Kliegman RM. Necrotizing enterocolitis: treatment based on staging criteria. Pediatr Clin North Am. 1986;33:179–201. - DOI - PubMed - PMC
    1. Ting JY, Synnes A, Roberts A, Deshpandey A, Dow K, Yoon EW, et al. Association Between Antibiotic Use and Neonatal Mortality and Morbidities in Very Low-Birth-Weight Infants Without Culture-Proven Sepsis or Necrotizing Enterocolitis. JAMA Pediatr. 2016;170:1181–7. - DOI - PubMed

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