Development of a national neonatal intensive care unit-specific antimicrobial stewardship programme in Canada: protocol for a cohort study
Introduction Early empiric treatment with broad-spectrum antimicrobials is common in neonatal intensive care units (NICU) due to the non-specific clinical presentation of infection. However, excessive and inappropriate antimicrobial use can lead to the emergence of drug-resistant organisms and adver...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2020-12-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/12/e043403.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850151564758482944 |
|---|---|
| author | Joan L Robinson Lindsay L Richter Prakesh S Shah Kyong-Soon Lee Vibhuti Shah Nisha Thampi Eugene Yoon Joseph Y. Ting Ashley Roberts Peter Tilley Michael S Dunn Vanessa Paquette Abhay Lodha Sandesh Shivananda Julie Autmizguine |
| author_facet | Joan L Robinson Lindsay L Richter Prakesh S Shah Kyong-Soon Lee Vibhuti Shah Nisha Thampi Eugene Yoon Joseph Y. Ting Ashley Roberts Peter Tilley Michael S Dunn Vanessa Paquette Abhay Lodha Sandesh Shivananda Julie Autmizguine |
| author_sort | Joan L Robinson |
| collection | DOAJ |
| description | Introduction Early empiric treatment with broad-spectrum antimicrobials is common in neonatal intensive care units (NICU) due to the non-specific clinical presentation of infection. However, excessive and inappropriate antimicrobial use can lead to the emergence of drug-resistant organisms and adverse neonatal outcomes. This study aims to develop and implement a nationwide NICU-specific antimicrobial stewardship programme (ASP) to promote judicious antimicrobial use and control the emergence of multidrug-resistant organisms (MDROs) in Canada.Methods and analysis Our study population will include all very low-birth-weight neonates admitted to participating tertiary NICU in Canada. Based on the existing limited literature, we will develop consensus on NICU antimicrobial stewardship interventions to enhance best practices. Using an expanded Canadian Neonatal Network (CNN) platform, we will collect data on antimicrobial use and the susceptibility of organisms identified in clinical samples from blood and cerebrospinal fluid over a period of 2 years. These data will be used to provide all NICU stakeholders with benchmarked centre-adjusted antimicrobial use and MDRO prevalence reports. An ASP plan will be developed at both individual unit and national levels in the subsequent years. Knowledge translation strategies will be implemented through the well-established Evidence-based Practice for Improving Quality methodology.Ethics and dissemination Ethics for the study has been granted by the University of British Columbia Children’s & Women’s Research Ethics Board (H19-02490) and supported by CNN Executive Committee. The study results will be disseminated through national organisations and open access peer-reviewed publications.Trial registration number NCT04388293. |
| format | Article |
| id | doaj-art-25bacad1e97b444d9ba9474861e3da5f |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-25bacad1e97b444d9ba9474861e3da5f2025-08-20T02:26:11ZengBMJ Publishing GroupBMJ Open2044-60552020-12-01101210.1136/bmjopen-2020-043403Development of a national neonatal intensive care unit-specific antimicrobial stewardship programme in Canada: protocol for a cohort studyJoan L Robinson0Lindsay L Richter1Prakesh S Shah2Kyong-Soon Lee3Vibhuti Shah4Nisha Thampi5Eugene Yoon6Joseph Y. Ting7Ashley Roberts8Peter Tilley9Michael S Dunn10Vanessa Paquette11Abhay Lodha12Sandesh Shivananda13Julie Autmizguine14Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada1 Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, British Columbia, CanadaMaternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, CanadaDepartment of Pediatrics, University of Toronto, Toronto, Ontario, CanadaDepartment of Paediatrics, Mount Sinai Hospital, Toronto, Ontario, CanadaDepartment of Pediatrics, University of Ottawa, Ottawa, Ontario, CanadaMaternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, CanadaPediatrics, University of British Columbia, Vancouver, British Columbia, CanadaDepartment of Pediatrics, University of British Columbia, Vancouver, British Columbia, CanadaPathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, CanadaDepartment of Pediatrics, University of Toronto, Toronto, Ontario, CanadaSchool of Pharmaceutical Science, University of British Columbia, Vancouver, British Columbia, CanadaDepartment of Pediatrics, University of Calgary, Calgary, Alberta, CanadaDepartment of Pediatrics, University of British Columbia, Vancouver, British Columbia, CanadaDepartment of Pediatrics, University of Montreal, Montreal, Québec, CanadaIntroduction Early empiric treatment with broad-spectrum antimicrobials is common in neonatal intensive care units (NICU) due to the non-specific clinical presentation of infection. However, excessive and inappropriate antimicrobial use can lead to the emergence of drug-resistant organisms and adverse neonatal outcomes. This study aims to develop and implement a nationwide NICU-specific antimicrobial stewardship programme (ASP) to promote judicious antimicrobial use and control the emergence of multidrug-resistant organisms (MDROs) in Canada.Methods and analysis Our study population will include all very low-birth-weight neonates admitted to participating tertiary NICU in Canada. Based on the existing limited literature, we will develop consensus on NICU antimicrobial stewardship interventions to enhance best practices. Using an expanded Canadian Neonatal Network (CNN) platform, we will collect data on antimicrobial use and the susceptibility of organisms identified in clinical samples from blood and cerebrospinal fluid over a period of 2 years. These data will be used to provide all NICU stakeholders with benchmarked centre-adjusted antimicrobial use and MDRO prevalence reports. An ASP plan will be developed at both individual unit and national levels in the subsequent years. Knowledge translation strategies will be implemented through the well-established Evidence-based Practice for Improving Quality methodology.Ethics and dissemination Ethics for the study has been granted by the University of British Columbia Children’s & Women’s Research Ethics Board (H19-02490) and supported by CNN Executive Committee. The study results will be disseminated through national organisations and open access peer-reviewed publications.Trial registration number NCT04388293.https://bmjopen.bmj.com/content/10/12/e043403.full |
| spellingShingle | Joan L Robinson Lindsay L Richter Prakesh S Shah Kyong-Soon Lee Vibhuti Shah Nisha Thampi Eugene Yoon Joseph Y. Ting Ashley Roberts Peter Tilley Michael S Dunn Vanessa Paquette Abhay Lodha Sandesh Shivananda Julie Autmizguine Development of a national neonatal intensive care unit-specific antimicrobial stewardship programme in Canada: protocol for a cohort study BMJ Open |
| title | Development of a national neonatal intensive care unit-specific antimicrobial stewardship programme in Canada: protocol for a cohort study |
| title_full | Development of a national neonatal intensive care unit-specific antimicrobial stewardship programme in Canada: protocol for a cohort study |
| title_fullStr | Development of a national neonatal intensive care unit-specific antimicrobial stewardship programme in Canada: protocol for a cohort study |
| title_full_unstemmed | Development of a national neonatal intensive care unit-specific antimicrobial stewardship programme in Canada: protocol for a cohort study |
| title_short | Development of a national neonatal intensive care unit-specific antimicrobial stewardship programme in Canada: protocol for a cohort study |
| title_sort | development of a national neonatal intensive care unit specific antimicrobial stewardship programme in canada protocol for a cohort study |
| url | https://bmjopen.bmj.com/content/10/12/e043403.full |
| work_keys_str_mv | AT joanlrobinson developmentofanationalneonatalintensivecareunitspecificantimicrobialstewardshipprogrammeincanadaprotocolforacohortstudy AT lindsaylrichter developmentofanationalneonatalintensivecareunitspecificantimicrobialstewardshipprogrammeincanadaprotocolforacohortstudy AT prakeshsshah developmentofanationalneonatalintensivecareunitspecificantimicrobialstewardshipprogrammeincanadaprotocolforacohortstudy AT kyongsoonlee developmentofanationalneonatalintensivecareunitspecificantimicrobialstewardshipprogrammeincanadaprotocolforacohortstudy AT vibhutishah developmentofanationalneonatalintensivecareunitspecificantimicrobialstewardshipprogrammeincanadaprotocolforacohortstudy AT nishathampi developmentofanationalneonatalintensivecareunitspecificantimicrobialstewardshipprogrammeincanadaprotocolforacohortstudy AT eugeneyoon developmentofanationalneonatalintensivecareunitspecificantimicrobialstewardshipprogrammeincanadaprotocolforacohortstudy AT josephyting developmentofanationalneonatalintensivecareunitspecificantimicrobialstewardshipprogrammeincanadaprotocolforacohortstudy AT ashleyroberts developmentofanationalneonatalintensivecareunitspecificantimicrobialstewardshipprogrammeincanadaprotocolforacohortstudy AT petertilley developmentofanationalneonatalintensivecareunitspecificantimicrobialstewardshipprogrammeincanadaprotocolforacohortstudy AT michaelsdunn developmentofanationalneonatalintensivecareunitspecificantimicrobialstewardshipprogrammeincanadaprotocolforacohortstudy AT vanessapaquette developmentofanationalneonatalintensivecareunitspecificantimicrobialstewardshipprogrammeincanadaprotocolforacohortstudy AT abhaylodha developmentofanationalneonatalintensivecareunitspecificantimicrobialstewardshipprogrammeincanadaprotocolforacohortstudy AT sandeshshivananda developmentofanationalneonatalintensivecareunitspecificantimicrobialstewardshipprogrammeincanadaprotocolforacohortstudy AT julieautmizguine developmentofanationalneonatalintensivecareunitspecificantimicrobialstewardshipprogrammeincanadaprotocolforacohortstudy |