Hostname: page-component-848d4c4894-8bljj Total loading time: 0 Render date: 2024-06-15T11:51:39.631Z Has data issue: false hasContentIssue false

Variation in antibiotic use among neonatal intensive care units in the United States

Published online by Cambridge University Press:  09 September 2021

Hillary J.J. Spencer
Division of Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
Keerti L. Dantuluri
Division of Pediatric Infectious Diseases and Immunology at Levine Children’s Hospital at Atrium Health, Charlotte, North Carolina
Cary Thurm
Children’s Hospital Association, Overland Park, Kansas City, Kansas
Hannah Griffith
Tennessee Department of Health, Nashville, Tennessee
Carlos G. Grijalva
Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee
Ritu Banerjee
Division of Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
Leigh M. Howard*
Division of Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
Author for correspondence: Leigh M. Howard, E-mail:


Antibiotics are widely used in neonatal intensive care units (NICUs). We conducted a cross-sectional analysis of antibiotic use across US NICUs to evaluate overall, broad-spectrum, and combination antibiotic use. Patterns of antibiotic use varied by medical versus surgical service line, hospital, and geographic location.

Concise Communication
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


PREVIOUS PRESENTATION. An abstract for this research was presented as Poster #1137 at IDWeek 2019 on October 4, 2019, in Washington, DC.


Patel, SJ, Oshodi, A, Prasad, P, et al. Antibiotic use in neonatal intensive care units and adherence with Centers for Disease Control and Prevention 12-step campaign to prevent antimicrobial resistance. Pediatr Infect Dis J 2009;28:10471051.CrossRefGoogle ScholarPubMed
Cotten, CM, Taylor, S, Stoll, B, et al. Prolonged duration of initial empirical antibiotic treatment is associated with increased rates of necrotizing enterocolitis and death for extremely low birth weight infants. Pediatrics 2009;123:5866.CrossRefGoogle ScholarPubMed
Grohskopf, LA, Huskins, WC, Sinkowitz-Cochran, RL, et al. Use of antimicrobial agents in US neonatal and pediatric intensive care patients. Pediatr Infect Dis J 2005;24:766773.CrossRefGoogle ScholarPubMed
Ho, T, Buus-Frank, ME, Edwards, EM, et al. Adherence of newborn-specific antibiotic stewardship programs to CDC recommendations. Pediatrics 2018;142(6). doi: 10.1542/peds.2017-4322.CrossRefGoogle ScholarPubMed
Schulman, J, Dimand, RJ, Lee, HC, Duenas, GV, Bennett, MV, Gould, JB. Neonatal intensive care unit antibiotic use. Pediatrics 2015;135:826833.CrossRefGoogle ScholarPubMed
Griffith, HG, Dantuluri, K, Thurm, C, et al. Considerable variability in antibiotic use among US children’s hospitals in 2017–2018. Infect Control Hosp Epidemiol 2020;41:571578.CrossRefGoogle ScholarPubMed
Howard, LM, Thurm, C, Dantuluri, K, et al. Parenteral antibiotic use among ambulatory children in US children’s hospital emergency departments. Open Forum Infect Dis 2020;7(10):ofaa357.CrossRefGoogle ScholarPubMed
Hicks, LA, Bartoces, MG, Roberts, RM, et al. US outpatient antibiotic prescribing variation according to geography, patient population, and provider specialty in 2011. Clin Infect Dis 2015;60:13081316.Google ScholarPubMed
Garland, A, Gershengorn, HB, Marrie, RA, Reider, N, Wilcox, ME. A practical, global perspective on using administrative data to conduct intensive care unit research. Ann ATS 2015;12:13731386.CrossRefGoogle ScholarPubMed
Feudtner, C, Feinstein, JA, Zhong, W, Hall, M, Dai, D. Pediatric complex chronic conditions classification system version 2: updated for ICD-10 and complex medical technology dependence and transplantation. BMC Pediatr 2014;14:199.CrossRefGoogle ScholarPubMed