Overuse of antibiotics in all settings accelerates the development of antibiotic resistance, a top threat to global health. Optimizing antibiotic use is a strategy for combatting resistance. Inter-hospital comparison of antibiotic use is recommended by national antibiotic stewardship implementation policies but requires accurate measurement of such use. Newborn infants admitted to neonatal intensive care units (NICUs) have high rates of antibiotic exposure. The purpose of this pharmacoepidemiology study is to provide a framework for safely optimizing neonatal antibiotic use. The project?s specific aims are (1) to develop a risk-adjusted method for benchmarking antibiotic use across NICUs; (2) to develop a neonatal antibiotic use metric that accounts for antibiotic spectrum of activity; and (3) to determine the associations between antibiotic use metrics and neonatal outcomes.
Aims 1 -3 will utilize neonatal data from the Premier Health Database and Aims 2 and 3 will also utilize University of Pennsylvania patient-level neonatal data for validation. This study will directly address a top AHRQ research priority, promoting appropriate antibiotic use in order to reduce the transmission of resistant bacteria. The proposal focuses exclusively on newborn infants, an AHRQ priority population. The results of this research will identify meaningful metrics of neonatal antibiotic use in order to allow hospitals and stakeholders to pinpoint antibiotic utilization practices that should be emulated or avoided, and ultimately improve the safety and quality of neonatal care. This career development award is designed to support the transition of Dr. Dustin Flannery, an Instructor of Pediatrics at the University of Pennsylvania and Children?s Hospital of Philadelphia, into an independent physician-scientist and to achieve his long-term career goal of becoming a national expert in neonatal antibiotic stewardship and leader in pediatric health services research. In addition, this award will allow him to obtain the training, mentorship, and research experience necessary to successfully compete for R01 grants supporting studies in this arena. Dr. Flannery will receive advanced training and experiential learning in pharmacoepidemiology research methods, advanced biostatistical techniques, and health services and policy. The University of Pennsylvania and Children?s Hospital of Philadelphia provide a stellar research environment to conduct such research. This project will be guided by a renowned mentorship team with a track record of successful collaboration and scholarship, including experts in neonatology, infectious diseases, pharmacoepidemiology, health services, biostatistics, and outcomes research.
Optimizing antibiotic use is an immediate task to curtail antibiotic resistance and is an AHRQ research priority area. In order to safely optimize antibiotic use among newborn infants, an AHRQ priority population, accurate measurement of antibiotic use is required. The purpose of this pharmacoepidemiology study is to identify meaningful metrics of neonatal antibiotic use in order to allow hospitals and stakeholders to pinpoint antibiotic utilization practices that should be emulated or avoided, and ultimately improve the safety and quality of neonatal care.
