Dr. Scipion and a global team of researchers are helping improve treatment in neonatal intensive care units (NICUs) by investigating antibiotic usage.
Dr. Catherine Scipion, Health Equity International/St. Boniface Hospital’s (HEI/SBH) academic affairs coordinator, is the co-author of a paper recently published in The Lancet’s online journal EClinicalMedicine. Titled A Global Point Prevalence Survey of Antimicrobial Use in Neonatal Intensive Care Units, the goal of the paper was to assess how and why antimicrobial agents (medicines like antibiotics that kill bacteria) are used in NICUs around the world. In total, 84 different hospitals across 29 counties participated in the study. Fifteen of the countries were high-income and 14 were middle- to low-income. SBH was the only healthcare facility from Haiti in the study.
While antimicrobial agents can save lives in NICUs, their overuse can have adverse consequences for patients and public health at large. The emergence of multidrug-resistant organisms and higher health costs are two such consequences. However, clinicians aren't using antimicrobial agents in NICUs without reason. Symptoms of infection in NICU infants can be virtually identical to symptoms of other common conditions, such as prematurity. “[Premature births] are a challenge in NICUs, especially when you are looking at diagnosing a possible infection,” explains Dr. Scipion. “There are several features of prematurity that are similar to those of infection.” Because of the similarities between the two conditions, antibiotics are often used as a preventative measure against a suspected infection. Unfortunately, this protocol is what can lead to potentially dangerous antibiotic overuse.
Dr. Scipion and her fellow researchers believe that their findings can help refine protocols around the use of antimicrobial agents to maximize their benefits and minimize the hazards of overuse.
[Premature births] are a challenge in NICUs, especially when you are looking at diagnosing a possible infection.
Dr. Catherine Scipion
Dr. Scipion and her co-authors found that of the 2,265 infants in the study, 580 (26%) were on at least one antimicrobial agent when they conducted the one-day point of prevalence study on July 1, 2019. Ruling out sepsis was the most common reason for administering antibiotics in every hospital, regardless of country or income level. They also found that healthcare facilities with NICU-specific antibiotic stewardship programs (ASPs) had significantly lower antibiotic usage rates, regardless of the country’s income level. The team concluded that antibiotic therapies were used in each hospital regardless of whether or not the patient had evidence of infection. They also concluded that there were no differences in the length of antimicrobial therapy, regardless of country, income level, or presence of ASPs. However, because ASPs were associated with significantly reduced antimicrobial usage, the researchers suggest that ASPs be implemented more broadly worldwide.
Thanks in large part to Dr. Scipion’s work, SBH is developing its own ASP to ensure our most vulnerable infants receive the most targeted care possible. In doing so, Dr. Scipion will continue to strengthen and elevate research at HEI/SBH.