{"doi":"10.1093/jpids/piaa022","title":"Influence of Patient Characteristics on Antibiotic Use Rates Among Preterm Infants","abstract":"BACKGROUND: The antibiotic use rate (AUR) has emerged as a potential metric for neonatal antibiotic use, but reported center-level AURs are limited by differences in case mix. The objective of this study was to identify patient characteristics associated with AUR among a large cohort of preterm infants. METHODS: Retrospective observational study using the Optum Neonatal Database, including infants born from January 1, 2010 through November 30, 2016 with gestational age 23-34 weeks admitted to neonatal units across the United States. Exposures were patient-level characteristics including length of stay, gestational age, sex, race/ethnicity, bacterial sepsis, necrotizing enterocolitis, and survival status. The primary outcome was AUR, defined as days with ≥ 1 systemic antibiotic administered divided by length of stay. Descriptive statistics, univariable comparative analyses, and generalized linear models were utilized. RESULTS: Of 17 910 eligible infants, 17 836 infants (99.6%) from 1090 centers were included. Median gestation was 32.9 (interquartile range [IQR], 30.3-34) weeks. Median length of stay was 25 (IQR, 15-46) days and varied by gestation. Overall median AUR was 0.13 (IQR, 0-0.26) and decreased over time. Gestational age, sex, and race/ethnicity were independently associated with AUR (P < .01). AUR and gestational age had an unexpected inverse parabolic relationship, which persisted when only surviving infants without bacterial sepsis or necrotizing enterocolitis were analyzed. CONCLUSIONS: Neonatal AURs are influenced by patient-level characteristics besides infection and survival status, including gestational age, sex, and race/ethnicity. Neonatal antibiotic use metrics that account for patient-level characteristics as well as morbidity case mix may allow for more accurate comparisons and better inform neonatal antibiotic stewardship efforts.","journal":"Journal of the Pediatric Infectious Diseases Society","year":2020,"id":88060,"datarank":0.3596842909197557,"base_score":2.3978952727983707,"endowment":2.3978952727983707,"self_citation_contribution":0.3596842909197557,"citation_network_contribution":0.0,"self_endowment_contribution":0.3596842909197557,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":10,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.6953,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":261808,"name":"Sagori Mukhopadhyay","orcid":"0000-0002-5851-8414","position":1,"is_corresponding":false},{"id":428052,"name":"Erik A. Jensen","orcid":"0000-0002-9179-8032","position":2,"is_corresponding":false},{"id":91692,"name":"Jeffrey S. Gerber","orcid":"0000-0002-3076-3186","position":3,"is_corresponding":false},{"id":448157,"name":"Molly R. Passarella","orcid":null,"position":4,"is_corresponding":false},{"id":439243,"name":"Kevin Dysart","orcid":"0000-0003-2715-2293","position":5,"is_corresponding":false},{"id":426823,"name":"Zubair H. Aghai","orcid":"0000-0001-5545-9706","position":6,"is_corresponding":false},{"id":427574,"name":"Jay S. Greenspan","orcid":null,"position":7,"is_corresponding":false},{"id":230760,"name":"Karen M. Puopolo","orcid":"0000-0002-5581-8825","position":8,"is_corresponding":false},{"id":261806,"name":"Dustin D. Flannery","orcid":"0000-0003-2883-4683","position":0,"is_corresponding":true}],"reference_count":37,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-18T22:00:56.736935Z","pmid":"32170951","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}