Media Stories on NICU Outbreaks Lead to an Increased Prescription Rate of Third-Line Antibiotics in the Community of Neonatal Care

The German Neonatal Network (GNN), Christoph Härtel*, Annika Hartz, Lina Bahr, Christian Gille, Ludwig Gortner, Arne Simon, Thorsten Orlikowsky, Andreas Müller, Thorsten Körner, Philipp Henneke, Roland Haase, Michael Zemlin, Dorothee Viemann, Corinna Gebauer, Ulrich Thome, Andreas Ziegler, Jan Rupp, Egbert Herting, Wolfgang GöpelStefan Avenarius, Kai Bockenholt, Bettina Bohnhorst, Michael Dördelmann, Hubert Gerleve, Freidhelm Heitmann, Peter Groneck, Joachim Eichhorn, Georg Hillebrand, Thomas Hoehn, Mechthild Hubert, Helmut Hummler, Andreas Jenke, Reinhard Jensen, Olaf Kannt, Helmut Küster, Reinhard Laux, Susanne Schmidtke, Ursula Lieser, Michael Mögel, Jens Möller, Dirk Müller, Jochen Reese, Claudia Roll, Thomas Schaible, Stefan Seeliger, Hugo Segerer, Norbert Teig, Ursula Weller, Matthias Vochem, Jürgen Wintgens

*Corresponding author for this work
2 Citations (Scopus)


BACKGROUND Between 2010 and 2012, 3 outbreaks of nosocomial infections in German neonatal intensive care units (NICUs) attracted considerable public interest. Headlines on national television channels and in newspapers had important consequences for the involved institutions and a negative impact on the relationship between families and staff in many German NICUs. OBJECTIVE To determine whether NICU outbreaks reported in the media influenced provider behavior in the community of neonatal care and led to more third-line antibiotic prescribing. DESIGN Observational cohort study. METHODS To investigate secular trends, we evaluated data for very-low-birth-weight infants (VLBWIs, birth weight <1,500 g) enrolled in the German Neonatal Network (GNN) between 2009 and 2014 (N=10,253). For outbreak effects, we specifically analyzed data for VLBWIs discharged 6 months before (n=2,428) and 6 months after outbreaks (n=2,508). RESULTS The exposure of all VLBWIs to third-line antibiotics increased after outbreaks (19.4% before vs 22.5% after; P=.007). This trend particularly affected male infants (4.6% increase; P=.005) and infants with a birth weight between 1,000 and 1,499 g (3.5% increase; P=.001) In a logistic regression analysis, month of discharge as linear variable of time was associated with increased exposure to third-line antibiotics (odds ratio [OR], 1.01; 95% confidence interval [CI], 1.009-1.014; P<.001), and discharge within the 6-month period after outbreak reports independently contributed to this long-term trend (OR, 1.14; 95% CI, 1.017-1.270; P=.024). CONCLUSIONS Media reports directly affect medical practice, eg, overuse of third-line antibiotics. Future communication and management strategies must be based on objective dialogues between the scientific community and investigative journalists.

Original languageEnglish
JournalInfection Control and Hospital Epidemiology
Issue number8
Pages (from-to)924-930
Number of pages7
Publication statusPublished - 01.08.2016


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