The Association between Prolonged Antibiotic Use in Culture Negative Infants and Length of Hospital Stay and Total Hospital Costs

Abstract

Objective This study aimed to determine if prolonged antibiotic use at birth in neonates with a negative blood culture increases the total cost of hospital stay.

Study design This was a retrospective study performed at a 60-bed level IV neonatal intensive care unit. Neonates born <30 weeks of gestation or <1,500 g between 2016 and 2018 who received antibiotics were included. A multivariate linear regression analysis was conducted to determine if clinical factors contributed to increased hospital cost or length of stay.

Results In total, 190 patients met inclusion criteria with 94 infants in the prolonged antibiotic group and 96 in the control group. Prolonged antibiotic use was associated with an increase length of hospital stay of approximately 31.87 days, resulting in a $69,946 increase in total cost of hospitalization.

Conclusion Prolonged antibiotics in neonates with negative blood culture were associated with significantly longer hospital length of stay and increased total cost of hospitalization.

Key Points

• Prolonged antibiotic use at birth is associated with prolonged hospital stay.

• Prolonged antibiotic use at birth is associated with increased cost of hospitalization.

• Prolonged antibiotic use at birth is associated with increased days on total parenteral nutrition.

• Prolonged antibiotic use at birth is associated with increased subsequent courses of antibiotics.

Keywords

prolonged antibiotic use - length of stay - total hospital cost - antibiotic stewardship

Authors' Contributions

W.S. drafted the initial manuscript, completed the data collection, and revised the final paper. V.S. assisted with data collection and reviewed the final paper. M.S. performed the statistical analysis of the data and reviewed the final paper. J.B. conceptualized and designed the study and reviewed the final paper. E.R.L. reviewed and edited the manuscript. D.N. assisted with the study design, reviewed, and edited the manuscript. S.K.J. reviewed and revised the manuscript for important intellectual content in addition to conceptualizing the study. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Publication History

Received: 06 August 2020

Accepted: 16 March 2021

Article published online:
11 May 2021

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