Background

Antibiotics are often used in Neonatal Intensive Care Units (NICUs) for babies suspected of having infections. The decision to stop these antibiotics usually depends on the baby’s health and the results of blood tests. Sometimes, delays in getting these test results can lead to longer antibiotic use.

Objective

We wanted to see if having a blood culture system (BACTEC) available right in the NICU could help reduce the time antibiotics are given when they are not needed.

Study Details

This study took place in a NICU from November 2021 to April 2023. We included newborns who were suspected of having infections and needed antibiotics for the first time. Babies were randomly assigned to either have their blood tests done in the NICU or sent to a central lab.

Main Findings

A total of 268 babies participated in the study, with 132 in the NICU group and 136 in the central lab group. Here are the results:

The average number of antibiotic doses was similar in both groups: 13 doses in the NICU group and 12 doses in the central lab group.
In the NICU group, 25% of babies had their antibiotics stopped within 48 hours, compared to 19.9% in the central lab group.
For those who had antibiotics stopped early (before 48 hours), the average number of doses was lower in the NICU group (5.6 doses) than in the central lab group (6.3 doses).
There were no significant differences in serious outcomes such as death or severe infections between the two groups.
The average time to get final test results from the central lab was about 131 hours.

Conclusions

The study showed that using the point of care BACTEC system in the NICU did not significantly reduce the total number of antibiotic doses. However, it did help some babies stop antibiotics earlier. More studies are needed with larger groups to confirm these findings.

Next Steps

Measurable Outcomes

We aim to establish clear goals for using point of care systems to reduce unnecessary antibiotic use in NICUs.

AI Tools for Clinical Needs

We will select AI solutions suited for improving antibiotic management based on our study findings.

Implementation Plan

We recommend starting with a pilot project to track results effectively and assess how AI tools can enhance the use of blood culture systems in NICUs.