Antimicrobial therapy utilization in neonates with hypoxic-ischemic encephalopathy (HIE): a report from the Children's Hospital Neonatal Database (CHND).

Quantify antimicrobial therapy (AMT) use in newborns with hypoxic-ischemic encephalopathy treated with therapeutic hypothermia (HIE/TH). Newborns with HIE/TH were identified from the Children's Hospital Neonatal Database (CHND). Early infection (onset ≤7 days of life) was defined as "confirmed" (culture proven) or "suspected infection" (culture negative but treated) and compared with a "no infection" group. 1501/1534 (97.8%) neonates received AMT. 36 (2.3%) had confirmed, 255 (16.6%) suspected, and 1243 (81.0%) had no infection. The median (IQR) AMT duration was 13 (8-21), 8 (7-10), and 3 (3-7) days for the three groups, respectively (p < 0.001). amt duration of use varied significantly across centers, adjusted for covariates (or 1.88, 95% ci: 1.43-2.46). incidence of early confirmed infection in neonates with hie th (23 1000) is significantly higher than reported rates of early onset sepsis in term and near term infants (0.5-1.0 1000 live births). antimicrobial-stewardship opportunities exist in infants with negative cultures.>

DOI 10.1038/s41372-019-0527-2