{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T04:26:06Z","timestamp":1780115166949,"version":"3.54.0"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2018,5,28]],"date-time":"2018-05-28T00:00:00Z","timestamp":1527465600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"UnityPoint Health\u2013Meriter Foundation","award":["578"],"award-info":[{"award-number":["578"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,9,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Meeting antibiotic stewardship goals in the neonatal intensive care unit (NICU) is challenging because of the unique nature of newborns and the lack of specificity of clinical signs of sepsis. Antibiotics are commonly continued for 48 hours pending culture results and clinical status. The goal of this study was to examine if the implementation of a 48-hour automatic stop (autostop) order during NICU admissions would decrease antibiotic use at UnityPoint Health\u2013Meriter.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>An observational double-cohort study was performed in a level 3 NICU. Antibiotic use was evaluated before and after the autostop initiative. The admission order set included 48 hours of ampicillin and gentamicin coverage.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>After the autostop initiation, total doses given per patient decreased by 35% and doses per patient-day decreased by 25% (P &lt; .0001). The greatest effect was a 66% decrease in the use of vancomycin, an antibiotic not included in the admission order set. Providers proactively continued antibiotics for infants in whom they had high suspicion for sepsis and in those with positive blood or cerebral spinal fluid culture results.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>An admission-order autostop was highly effective at decreasing antibiotic usage with no doses intended for a pathogen missed. Fewer doses of certain antibiotics outside of the admission order set were administered, particularly vancomycin, which results in our speculation that provider awareness of the antibiotic stewardship initiative might have altered prescribing practices.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jpids\/piy043","type":"journal-article","created":{"date-parts":[[2018,5,2]],"date-time":"2018-05-02T03:08:26Z","timestamp":1525230506000},"page":"310-316","source":"Crossref","is-referenced-by-count":50,"title":["Antibiotic Stewardship in the Neonatal Intensive Care Unit: Effects of an Automatic 48-Hour Antibiotic Stop Order on Antibiotic Use"],"prefix":"10.1093","volume":"8","author":[{"given":"Maria Corazon","family":"Astorga","sequence":"first","affiliation":[{"name":"Pediatrics Department, University of Wisconsin\u2013Madison"},{"name":"UnityPoint Health\u2013Meriter, Madison, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle J","family":"Piscitello","sequence":"additional","affiliation":[{"name":"Pediatrics Department, University of Wisconsin\u2013Madison"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Menda","sequence":"additional","affiliation":[{"name":"Pediatrics Department, University of Wisconsin\u2013Madison"},{"name":"UnityPoint Health\u2013Meriter, Madison, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann M","family":"Ebert","sequence":"additional","affiliation":[{"name":"UnityPoint Health\u2013Meriter, Madison, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven C","family":"Ebert","sequence":"additional","affiliation":[{"name":"UnityPoint Health\u2013Meriter, Madison, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A","family":"Porte","sequence":"additional","affiliation":[{"name":"Pediatrics Department, University of Wisconsin\u2013Madison"},{"name":"UnityPoint Health\u2013Meriter, Madison, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela J","family":"Kling","sequence":"additional","affiliation":[{"name":"Pediatrics Department, University of Wisconsin\u2013Madison"},{"name":"UnityPoint Health\u2013Meriter, Madison, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2018,5,28]]},"reference":[{"key":"2019100522582818800_CIT0001","doi-asserted-by":"crossref","first-page":"2357","DOI":"10.1001\/jama.292.19.2357","article-title":"Neurodevelopmental and growth impairment among extremely low-birth-weight infants with neonatal infection","volume":"292","author":"Stoll","year":"2004","journal-title":"JAMA"},{"key":"2019100522582818800_CIT0002","doi-asserted-by":"crossref","first-page":"e736","DOI":"10.1542\/peds.2009-2017","article-title":"Outcome of early-onset sepsis in a national cohort of very low birth weight infants","volume":"125","author":"Klinger","year":"2010","journal-title":"Pediatrics"},{"key":"2019100522582818800_CIT0003","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1038\/sj.jp.7211068","article-title":"Mortality following blood culture in premature infants: increased with Gram-negative bacteremia and candidemia, but not Gram-positive bacteremia","volume":"24","author":"Benjamin","year":"2004","journal-title":"J Perinatol"},{"key":"2019100522582818800_CIT0004","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1097\/00006454-199807000-00004","article-title":"Incidence, presenting features, risk factors and significance of late onset septicemia in very low birth weight infants. 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