Fellow Johns Hopkins Johns Hopkins University Washington, District of Columbia, United States
Background: Antibiotic use for early onset neonatal sepsis (EONS) in India is common. While lifesaving for infected neonates, prolonged antibiotic use for uninfected neonates has been associated with adverse patient outcomes as well as increased antibiotic resistance. Better understanding of antibiotic prescribing practices for EONS is needed, including the impact of organizational factors on the variation in EONS management. Objective: To understand current antibiotic prescribing practices for EONS amongst neonatologists in India and examine the association between institutional capacity related to infection prevention initiatives and the variation in management. Design/Methods: This vignette study examines antibiotic prescribing practices for EONS and the institutional capacity of neonatal providers in India. The survey includes five vignette-based scenarios to assess EONS practice that were modeled on existing surveys studying empiric antibiotic use in North America and Europe. Additional questions were included to assess laboratory infrastructure and infection prevention initiatives such as the availability of institutional guidelines or antibiotic stewardship programs. The survey was approved by an Institutional Review Board in the United States and the Ethics Committee of a hospital research center in India. The anonymous survey was distributed via email and instant messaging to neonatal providers in India. Responses will be collected from September 15 until December 1, 2023. Data analysis will include descriptive statistics of responding providers and reported institutional infection prevention initiatives. Results on EONS practice from vignettes will be dichotomized. Chi-squared or Fischer’s exact test will be used, as appropriate, to assess association between institutional factors (for example, size of hospital, availability of on-site microbiology testing, institutional stewardship program) and prescribing preferences including starting empiric antibiotics and duration of empiric antibiotics.
