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ABSTRACT

Antibiotic stewardship in the neonatal intensive care unit (NICU) has drawn much attention over the last decade following reports of antibiotic overuse and unexplained prescribing variation^1,2 and reports showing association between antibiotic use and multiple adverse outcomes, including necrotizing enterocolitis, late-onset sepsis, retinopathy of prematurity, and bronchopulmonary dysplasia.^3–6 Antibiotic use has also been linked with emergence of fungal infections, multidrug-resistant bacteria, and disturbances in the developing microbiome.^7–9 In response, emphasis has been placed on quality improvement (QI) to drive antibiotic stewardship, with many local unit-based initiatives as well as larger-scale collaboratives reporting important efforts safely reducing antibiotic use in the NICU and neonatal care.^10–12