Document Detail


Prolonged initial empirical antibiotic treatment is associated with adverse outcomes in premature infants.
MedLine Citation:
PMID:  21784435     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the outcomes after prolonged empirical antibiotic administration to premature infants in the first week of life, and concluding subsequent late onset sepsis (LOS), necrotizing enterocolitis (NEC), and death.
STUDY DESIGN: Study infants were ≤ 32 weeks gestational age and ≤ 1500 g 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 that control 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 who survived 7 days free of sepsis or NEC, 36% received prolonged initial empirical antibiotics, which was independently associated with subsequent outcomes: LOS (OR, 2.45 [95% 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.
Authors:
Venkata S Kuppala; Jareen Meinzen-Derr; Ardythe L Morrow; Kurt R Schibler
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-07-23
Journal Detail:
Title:  The Journal of pediatrics     Volume:  159     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-10-14     Completed Date:  2011-12-29     Revised Date:  2014-03-19    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  720-5     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 Mosby, Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Anti-Bacterial Agents / administration & dosage*
Cohort Studies
Enteral Nutrition
Enterocolitis, Necrotizing / epidemiology*,  microbiology
Female
Humans
Infant Mortality*
Infant, Newborn
Infant, Premature*
Infant, Very Low Birth Weight
Intensive Care Units, Neonatal
Male
Milk, Human
Multivariate Analysis
Ohio / epidemiology
Registries
Retrospective Studies
Risk Factors
Sepsis / epidemiology*,  microbiology
Time Factors
Grant Support
ID/Acronym/Agency:
P01 HD013021-32/HD/NICHD NIH HHS; R01 HD059140-03/HD/NICHD NIH HHS; U10 HD027853/HD/NICHD NIH HHS; U10 HD027853-21/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents
Comments/Corrections
Comment In:
J Pediatr. 2011 Nov;159(5):707-8   [PMID:  21885065 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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