{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T12:31:32Z","timestamp":1794313892046,"version":"4.9.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Neonates with abdominal wall defects are at an increased infection risk because of the defect itself and prolonged neonatal intensive care unit (NICU) stays. Antibiotic prophylaxis until closure of the defect is common. However, infection risk and antibiotic use have not been well quantified in these infants.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>A retrospective cohort study of infants with abdominal wall defects (gastroschisis and omphalocele) admitted to a single-center NICU from 2007 to 2018. Demographic and clinical information, including microbiologic studies, antibiotic dosing and surgical care, were collected. Antibiotic use was quantified using days of therapy (DOT) per 1000 patient-days. Sepsis was defined as culture of a pathogen from a normally sterile site.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Seventy-four infants were included; 64 (86%) with gastroschisis and 10 (14%) with omphalocele. Median day of closure was 8 days [interquartile range (IQR) 6\u201310, range 0\u201331]. All infants received \u22651 course of antibiotics; median antibiotic DOT\/infant was 24.5 (IQR 18\u201336) for an average of 416.5 DOT per 1000 patient-days. Most antibiotic use was preclosure prophylaxis (44%) and treatment of small intestinal bowel overgrowth (24%). Suspected and proven infection accounted for 26% of all antibiotic use. Skin and soft tissue infection (13\/74, 18%) and late-onset sepsis (11\/74, 15%) were the most common infections; 2 infants had sepsis while on antibiotic prophylaxis. All infants survived to discharge.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Most antibiotic use among infants with abdominal wall defects was prophylactic. Infection on prophylaxis was rare, but 35% of infants had infection after prophylaxis. Improved stewardship strategies are needed for these high-risk infants.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/inf.0000000000002867","type":"journal-article","created":{"date-parts":[[2020,8,21]],"date-time":"2020-08-21T22:03:53Z","timestamp":1598047433000},"page":"1116-1120","source":"Crossref","is-referenced-by-count":13,"title":["Antibiotic Utilization and Infection Among Infants with Abdominal Wall Defects"],"prefix":"10.1097","volume":"39","author":[{"given":"Chandana","family":"Ravikumar","sequence":"first","affiliation":[{"name":"Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian C.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Surgery, University of Texas Health San Antonio, San Antonio, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph B.","family":"Cantey","sequence":"additional","affiliation":[{"name":"Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,8,22]]},"reference":[{"key":"R1-20230912","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1002\/bdr2.1607","article-title":"Population-based birth defects data in the United States, 2012-2016: a focus on abdominal wall defects.","volume":"111","author":"Stallings","year":"2019","journal-title":"Birth Defects Res"},{"key":"R2-20230912","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1007\/s00383-011-3038-6","article-title":"Infectious complications in the management of gastroschisis.","volume":"28","author":"Baird","year":"2012","journal-title":"Pediatr Surg Int"},{"key":"R3-20230912","doi-asserted-by":"crossref","first-page":"1782","DOI":"10.1016\/j.jpedsurg.2014.09.018","article-title":"Multi-institutional practice patterns and outcomes in uncomplicated gastroschisis: a report from the University of California Fetal Consortium (UCfC).","volume":"49","author":"Lusk","year":"2014","journal-title":"J Pediatr Surg"},{"key":"R4-20230912","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1155\/2011\/604643","article-title":"Diagnosis and pharmacological management of small intestinal bacterial overgrowth in children with intestinal failure.","volume":"25","author":"Malik","year":"2011","journal-title":"Can J Gastroenterol"},{"key":"R5-20230912","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1007\/s40272-015-0161-1","article-title":"Optimizing the use of antibacterial agents in the neonatal period.","volume":"18","author":"Cantey","year":"2016","journal-title":"Paediatr Drugs"},{"key":"R6-20230912","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1053\/j.sempedsurg.2019.04.005","article-title":"Paint and wait management of giant omphaloceles.","volume":"28","author":"Wagner","year":"2019","journal-title":"Semin Pediatr Surg"},{"key":"R7-20230912","doi-asserted-by":"crossref","first-page":"1178","DOI":"10.1016\/S1473-3099(16)30205-5","article-title":"Reducing unnecessary antibiotic use in the neonatal intensive care unit (SCOUT): a prospective interrupted time-series study.","volume":"16","author":"Cantey","year":"2016","journal-title":"Lancet Infect Dis"},{"key":"R8-20230912","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1097\/INF.0b013e3182011d12","article-title":"Effectiveness of a guideline to reduce vancomycin use in the neonatal intensive care unit.","volume":"30","author":"Chiu","year":"2011","journal-title":"Pediatr Infect Dis J"},{"key":"R9-20230912","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.idc.2014.01.006","article-title":"Antimicrobial use metrics and benchmarking to improve stewardship outcomes: methodology, opportunities, and challenges.","volume":"28","author":"Ibrahim","year":"2014","journal-title":"Infect Dis Clin North Am"},{"key":"R10-20230912","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1586\/eri.12.18","article-title":"Benchmarking antimicrobial drug use in hospitals.","volume":"10","author":"Ibrahim","year":"2012","journal-title":"Expert Rev Anti Infect Ther"},{"key":"R11-20230912","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1097\/INF.0000000000001570","article-title":"Late-onset sepsis in extremely premature infants: 2000-2011.","volume":"36","author":"Greenberg","year":"2017","journal-title":"Pediatr Infect Dis J"},{"key":"R13-20230912","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1097\/ANC.0b013e31821baaf4","article-title":"Necrotizing enterocolitis in the premature infant: neonatal nursing assessment, disease pathogenesis, and clinical presentation.","volume":"11","author":"Gregory","year":"2011","journal-title":"Adv Neonatal Care"},{"key":"R14-20230912","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1055\/s-0037-1607420","article-title":"Evaluation of early onset sepsis, complete blood count, and antibiotic use in gastroschisis.","volume":"35","author":"Williams","year":"2018","journal-title":"Am J Perinatol"},{"key":"R15-20230912","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1001\/archsurg.1973.01350200086020","article-title":"Gastroschisis: ten-year review.","volume":"107","author":"Lewis","year":"1973","journal-title":"Arch Surg"},{"key":"R16-20230912","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1007\/s00383-018-4349-7","article-title":"Single center protocol driven care in 150 patients with gastroschisis 1998-2017: collaboration improves results.","volume":"34","author":"Pearl","year":"2018","journal-title":"Pediatr Surg Int"},{"key":"R17-20230912","doi-asserted-by":"crossref","first-page":"1751","DOI":"10.1016\/j.jpedsurg.2017.02.008","article-title":"Does timing of gastroschisis repair matter? A comparison using the ACS NSQIP pediatric database.","volume":"52","author":"Gurien","year":"2017","journal-title":"J Pediatr Surg"},{"key":"R18-20230912","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.jpedsurg.2014.10.001","article-title":"Identifying strategies to decrease infectious complications of gastroschisis repair.","volume":"50","author":"Schlueter","year":"2015","journal-title":"J Pediatr Surg"},{"key":"R19-20230912","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1007\/s00383-018-4381-7","article-title":"Safety and usefulness of plastic closure in infants with gastroschisis: a systematic review and meta-analysis.","volume":"35","author":"Miyake","year":"2019","journal-title":"Pediatr Surg Int"},{"key":"R21-20230912","doi-asserted-by":"crossref","first-page":"2117","DOI":"10.1016\/j.jpedsurg.2018.06.014","article-title":"A Gastroschisis bundle: effects of a quality improvement protocol on morbidity and mortality.","volume":"53","author":"Zalles-Vidal","year":"2018","journal-title":"J Pediatr Surg"},{"key":"R22-20230912","first-page":"1643","article-title":"Deconjugation ability of bacteria isolated from the jejunal fluid of patients with progressive systemic sclerosis and its gastric pH.","volume":"45","author":"Shindo","year":"1998","journal-title":"Hepatogastroenterology"},{"key":"R23-20230912","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1016\/0016-5085(81)90012-3","article-title":"Protein-losing enteropathy in the human and experimental rat blind-loop syndrome.","volume":"80","author":"King","year":"1981","journal-title":"Gastroenterology"},{"key":"R24-20230912","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1016\/S0016-5085(19)32751-9","article-title":"Jejunal brush border injury and impaired sugar and amino acid uptake in the blind loop syndrome.","volume":"67","author":"Giannella","year":"1974","journal-title":"Gastroenterology"},{"key":"R25-20230912","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.cgh.2005.10.020","article-title":"Enteric microbial flora, bacterial overgrowth, and short-bowel syndrome.","volume":"4","author":"Dibaise","year":"2006","journal-title":"Clin Gastroenterol Hepatol"},{"key":"R26-20230912","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1097\/MCG.0000000000000814","article-title":"Probiotics for preventing and treating small intestinal bacterial overgrowth: a meta-analysis and systematic review of current evidence.","volume":"51","author":"Zhong","year":"2017","journal-title":"J Clin Gastroenterol"},{"key":"R27-20230912","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1055\/s-0038-1636916","article-title":"Surgical site infection in a tertiary neonatal surgery centre.","volume":"29","author":"Woldemicael","year":"2019","journal-title":"Eur J Pediatr Surg"},{"key":"R28-20230912","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.jpedsurg.2013.08.001","article-title":"Surgical site infections in infants admitted to the neonatal intensive care unit.","volume":"49","author":"Segal","year":"2014","journal-title":"J Pediatr Surg"},{"key":"R29-20230912","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1001\/jamasurg.2018.3216","article-title":"Evaluation of clinical outcomes of sutureless vs sutured closure techniques in gastroschisis repair.","volume":"154","author":"Witt","year":"2019","journal-title":"JAMA Surg"}],"container-title":["Pediatric Infectious Disease Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/INF.0000000000002867","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T23:00:15Z","timestamp":1694559615000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/INF.0000000000002867"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,22]]},"references-count":27,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1097\/inf.0000000000002867","relation":{},"ISSN":["0891-3668"],"issn-type":[{"value":"0891-3668","type":"print"}],"subject":[],"published":{"date-parts":[[2020,8,22]]}}}