Significant gaps exist between Centers for Disease Control (CDC) recommendations to improve antibiotic use and antibiotic practices during the newborn period, according to a recent investigation. There is wide variation in point prevalence antibiotic use rates (AURs) and three-quarters of infants who received antibiotics for >48 hours did not have infections proven by using cultures. Data were collected using a cross-sectional audit of Vermont Oxford Network members in February 2016. Unit measures were derived from the 7 domains of the CDC’s Core Elements of Hospital Antibiotic Stewardship Programs, including leadership commitment, accountability, drug expertise, action, tracking, reporting, and education. Researchers found:

• Overall, 143 centers completed structured self-assessments.
• No center addressed all 7 core elements.
• Of the 7, only accountability (55%) and drug expertise (62%) had compliance >50%.
• Centers audited 4,127 infants for current antibiotic exposure.
• There were 725 infants who received antibiotics, for a hospital median AUR of 17% (interquartile range 10%–26%).
• Of the 412 patients on >48 hours of antibiotics, only 26% (107 out of 412) had positive culture results.