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Sökning: WFRF:(Nakanishi Hidehiko)

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1.
  • Prusakov, Pavel, et al. (författare)
  • A global point prevalence survey of antimicrobial use in neonatal intensive care units : The no-more-antibiotics and resistance (NO-MAS-R) study
  • 2021
  • Ingår i: eClinicalMedicine. - : Elsevier. - 2589-5370. ; 32
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Global assessment of antimicrobial agents prescribed to infants in the neonatal intensive care unit (NICU) may inform antimicrobial stewardship efforts.Methods: We conducted a one-day global point prevalence study of all antimicrobials provided to NICU infants. Demographic, clinical, and microbiologic data were obtained including NICU level, census, birth weight, gestational/chronologic age, diagnoses, antimicrobial therapy (reason for use; length of therapy), antimicrobial stewardship program (ASP), and 30-day in-hospital mortality.Findings: On July 1, 2019, 26% of infants (580/2,265; range, 0-100%; median gestational age, 33 weeks; median birth weight, 1800 g) in 84 NICUs (51, high-income; 33, low-to-middle income) from 29 countries (14, high-income; 15, low-to-middle income) in five continents received >= 1 antimicrobial agent (92%, antibacterial; 19%, antifungal; 4%, antiviral). The most common reasons for antibiotic therapy were "rule-out" sepsis (32%) and "culture-negative" sepsis (16%) with ampicillin (40%), gentamicin (35%), amikacin (19%), vancomycin (15%), and meropenem (9%) used most frequently. For definitive treatment of presumed/confirmed infection, vancomycin (26%), amikacin (20%), and meropenem (16%) were the most prescribed agents. Length of therapy for culture-positive and "culture-negative" infections was 12 days (median; IQR, 8-14) and 7 days (median; IQR, 5-10), respectively. Mortality was 6% (42%, infection-related). An NICU ASP was associated with lower rate of antibiotic utilization (p = 0.02).Interpretation: Global NICU antibiotic use was frequent and prolonged regardless of culture results. NICU-specific ASPs were associated with lower antibiotic utilization rates, suggesting the need for their implementation worldwide.
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2.
  • Sindelar, Richard, Docent, 1964-, et al. (författare)
  • Respiratory Management for Extremely Premature Infants born at 22 to 23 weeks of Gestation in Proactive Centers in Sweden, Japan, and USA
  • 2022
  • Ingår i: Seminars in Perinatology. - : Elsevier. - 0146-0005 .- 1558-075X. ; 46:1, s. 151540-
  • Tidskriftsartikel (refereegranskat)abstract
    • Survival of preterm newborn infants have increased steadily since the introduction of surfactanttreatment and antenatal steroids. In the absence of randomized controlled trials onventilatory strategies in extremely preterm infants, we present ventilatory strategiesapplied during the initial phase and the continued ventilatory care as applied in three centerswith proactive prenatal and postnatal management and well documented good outcomesin terms of mortality and morbidity in this cohort of infants.
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