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Record W2611258562 · doi:10.1080/14767058.2017.1326896

Patient and prescriber factors and the prolongation of antibiotics after birth in infants less than 29 weeks

2017· article· en· W2611258562 on OpenAlexaff
Mohamad Rami Alturk, Ronald J Baier

Bibliographic record

VenueThe Journal of Maternal-Fetal & Neonatal Medicine · 2017
Typearticle
Languageen
FieldMedicine
TopicNeonatal and Maternal Infections
Canadian institutionsUniversity of Manitoba
Fundersnot available
KeywordsMedicineAntibioticsSepsisNeonatologyBacteremiaNeonatal sepsisBlood cultureRetrospective cohort studyPediatricsInternal medicinePregnancy

Abstract

fetched live from OpenAlex

OBJECTIVE: The objective of this study is to delineate whether patient-related or prescriber-related factors account for the prolongation of antibiotic therapy beyond 48 h in premature infants whose initial blood cultures are negative. METHODS: Retrospective review of infants born <29 weeks born between January 2011 and December 2012. Infants who had positive blood cultures or who died in the first 48 h were excluded from analysis. Antibiotic courses were categorized as prolonged if antibiotics were continued for greater than 48 h and not prolonged if antibiotics were stopped by 48 h. Neonatologists were classified as high prescribers if they prolonged antibiotics for more than the median rate for the overall group. RESULTS: Seventeen of 59 (29%) infants had empiric antibiotics continued for greater than 48 h despite negative blood cultures. Both patient-related factors and the neonatologist at 48 h of life were significantly associated with prolongation of antibiotics. Patient-related factors associated with prolongation of empiric antibiotics were positive maternal Group B streptococcus (GBS) status (5/17 versus 4/42); p = .054), white blood count >25,000 (7/17 versus 1/42); p < .001), rupture of membranes (ROM) duration (187 ± 253 h versus 47 ± 89 h; p = .015). Increased number of risk factors was associated with increased likelihood of prolongation. Risk factors for sepsis were similar between high and low prescribing neonatologists with high prescribers prolonging antibiotics with a lower number of risk factors. CONCLUSIONS: The decision to prolong empiric antibiotics in culture negative preterm infants is related both to patient and prescriber-related factors.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.029
Threshold uncertainty score0.350

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.001
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.013
GPT teacher head0.259
Teacher spread0.246 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations3
Published2017
Admission routes1
Has abstractyes

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