Prolonged Initial Empirical Antibiotic Treatment is Associated with Adverse Outcomes in Premature Infants
By V. S. Kuppala, J. Meinzen-Derr, A. Morrow, K. Schibler. Jornal de Pediatria, 2011
607 citations recorded by the source corpus.
Objective To investigate the outcomes following prolonged empirical antibiotic administration to premature infants in the first week of life, concluding subsequent late onset sepsis (LOS), necrotizing enterocolitis (NEC), and death. Study design Study infants were ≤32 weeks gestational age and ≤ 1500 grams birth weight who survived free of sepsis and NEC for 7 days. Multivariable logistic regression was conducted to determine independent relationships between prolonged initial empirical antibiotic therapy (≥ 5 days) and study outcomes controlling for birth weight, gestational age, race, prolonged premature rupture of membranes, days on high frequency ventilation in 7 days, and the amount of breast milk received in the first 14 days of life. Results Of the 365 premature infants surviving 7 days free of sepsis or NEC, 36% received prolonged initial empirical antibiotics, which was independently associated with subsequent outcomes: LOS (odds ratio [OR] 2.45, 95% confidence interval [CI] 1.28–4.67) and the combination of LOS, NEC, or death (OR 2.66, 95% CI 1.12–6.3). Conclusions Prolonged administration of empirical antibiotics to premature infants with sterile cultures in the first week of life is associated with subsequent severe outcomes. Judicious restriction of antibiotic use should be investigated as a strategy to reduce severe outcomes for premature infants.
Subfields: Nutrition and Dietetics, Public Health, Environmental and Occupational Health, Pulmonary and Respiratory Medicine
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In Nutrition and Dietetics
Citations in the corpus
- The effects of antibiotics on the microbiome throughout development and alternative approaches for therapeutic modulation (2016, background): “Extended antibiotic treatment (>5 days) in premature infants is associated with an increased risk of late-onset sepsis (primarily caused by group B Streptoccoccus), necrotizing enterocolitis, and overall mortality [39, 40].”
- Impact of antibiotics on the human microbiome and consequences for host health (2022, background): “Extended antibiotic treatment in premature infants can result in an increased risk of developing late‐onset sepsis (primarily caused by Group B Streptococcus), necrotizing enterocolitis (NEC), and overall mortality (Esaiassen et al., 2017; Kuppala et al., 2011).”