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Media reports of NICU outbreaks linked to increased antibiotic use
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Extensive media coverage of nosocomial infection outbreaks at three neonatal ICUs in Germany may have prompted overuse of third-line antibiotics, according to recent research in Infection Control & Hospital Epidemiology.
“Recently, a series of infection outbreaks in German NICUs was reported on national television channels and in newspapers,” Christoph Härtel, MD, of the pediatrics department at the University of Lübeck, and colleagues wrote. “Public awareness resulted in significant consequences for the affected hospitals, eg, extensive screening of patients and personnel, closure of units, and states’ attorneys investigations into negligent manslaughter. Whether increased public awareness of infection outbreaks affects provider behavior has never been investigated.”
The NICU outbreaks occurred between August 2010 and October 2012 at the University Children’s Hospital Mainz, the Children’s Hospital Bermen-Mitte and the Charité University Hospital Berlin. Pathogens included Escherichia coli, Enterobacter spp., Klebsiella pneumoniae and Serratia marcescens.
To determine if media reports influenced medical practice within NICUs, the researchers examined 10,253 very low birth weight infants from the German Neonatal Network admitted to 50 units from 2009 through 2014. Data from 6 months before the outbreaks occurred were compared with data from 6 months after the outbreaks to determine effects. The researchers also evaluated all print media and online reports regarding the outbreaks.
Study results showed that exposure to third-line antibiotics increased for all very low birth weight infants after the outbreaks were publicized, from a prevalence of 19.4% to 22.5% (P = .007). The researchers noted that this increase in prescribing behavior cannot be explained by epidemiological evidence.
Härtel and colleagues found that prescribing increases particularly affected boys, with a 4.6% increase (P = .005), and newborns weighing 1,000 g to 1,499 g, with a 3.5% increase (P = .001).
The researchers wrote that these changes were possibly caused because physicians may become risk averse during outbreaks, were forced to overprescribe due to institutional pressure or because understaffing could lead to antibiotic overuse.
“Media are important convectors of information, and they hugely influence public perceptions and responses,” Härtel and colleagues wrote. “This public interest can be used for educational purposes considering ongoing outbreaks and global challenges on antibiotic resistance. Instead of attacking each other, an objective dialogue between the scientific community and investigative journalists should be encouraged.” – by David Costill
Disclosure: The researchers report no relevant financial disclosures.
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