Antibiotic use for FN
Antibiotic use on day one of FN before and after PHIG intervention is
shown in Table 4 . Major differences in practice existed between
different PHO units prior to intervention. In units 1 and 2, triple
antibiotic therapy (i.e., an antipseudomonal beta-lactam, a second Gram
negative agent and a Gram-positive agent) was commonly practiced; in the
BMT unit monotherapy with an antipseudomonal beta-lactam was more
commonly used; in unit 5, double Gram-negative coverage was used; and in
unit 6, triple antibiotic therapy and other non-standard regimens were
frequently used. Significant improvements in appropriateness of
antibiotic prescribing were noted after the intervention
(p =0.005). For all units combined, antibiotic therapy was started
without obtaining cultures less frequently after the intervention (9.8%
versus 14.1% before, p =0.006). This practice was more frequent
in PHO units located in general compared to pediatric hospitals before
(25.5% compared to 9%) and after intervention (18.2% compared to
5.8%), and this difference was highly significant (p =0.001 for
both comparisons).