Original Research
Saturday, November 11, 2023
11:30 AM–01:00 PM
Abstract
Introduction: Neonatal sepsis and meningitis can have severe consequences if left untreated. Diagnosing meningitis in neonates is challenging as lumbar puncture is often performed after initiating antibiotics. This study aimed to assess the impact of the FilmArray Meningitis Encephalitis PCR Panel (MEPCRP) on antibiotic duration and outcomes in neonates with culture-negative bacterial meningitis (CNBM).
Research Question or Hypothesis: We hypothesized that MEPCRP testing could reduce antibiotic use by 20% in neonates treated for CNBM without increasing reinfection rate.
Study Design: A retrospective cohort study included neonates treated for CNBM who underwent lumbar puncture after antibiotic therapy.
Methods: Cohort 1 (PRE-Imp) comprised of neonates before MEPCRP implementation, while Cohort 2 (POST-Imp) included neonates after MEPCRP implementation. Primary outcomes were antibiotic duration and reinfection within 30 days. Secondary outcomes included mortality, hospitalization duration, central line placements, necrotizing enterocolitis (NEC), and early neurodevelopmental scores. Statistical analysis involved chi-square tests, t-tests, and regression analysis.
Results: The study analyzed 100 neonates (50 in each cohort) with similar baseline characteristics. Cohort 2 exhibited significantly shorter total antibiotic therapy duration (mean 7.6±2.4 vs 13.6±5.3 days, p< 0.0001) for CNBM compared to Cohort 1. No reinfections occurred within 30 days. Cohort 1 had prolonged central line placements and hospitalizations for antibiotic therapy than Cohort 2 (median 7 vs 3 days, p< 0.001; mean 14.8±5.7 vs 8.7±2.6 days, p<0.0001, respectively). Factors associated with prolonged antibiotic therapy (>10 days) included gestational age, birthweight, postmenstrual age, and the need for respiratory support. No significant differences were found in laboratory markers, mortality, NEC, vasopressor use, or neurodevelopmental scores.
Conclusion: MEPCRP testing in neonates with CNBM led to a substantial reduction in antibiotic duration, central line placements, and associated hospital stays without compromising patient outcomes. MEPCRP testing presents a valuable diagnostic tool that can optimize antibiotic use, reduce costs, and prevent adverse outcomes associated with prolonged antibiotic therapy in this vulnerable neonatal population.
Presenting Author
Shiyi Lan PharmD StudentUniversity of Illinois at Chicago
Authors
Jennifer Pham PharmD, BCPS, BCPPS
University of Illinois Chicago
Marta Ciolkowska PharmD Student
University of Illinois Chicago
Angelo Turla PharmD Student
University of Illinois Chicago
Isabel Xiao PharmD Student
University of Illinois Chicago