Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Sep-Oct;32(5):521-6.
doi: 10.5144/0256-4947.2012.521.

Empirical antibiotic treatment and the risk of necrotizing enterocolitis and death in very low birth weight neonates

Eman A Abdel Ghany  1 , Aliaa A Ali
Affiliations

Empirical antibiotic treatment and the risk of necrotizing enterocolitis and death in very low birth weight neonates

Eman A Abdel Ghany et al. Ann Saudi Med. 2012 Sep-Oct.

Abstract

Background and objectives: Antibiotics are one of the most overused drugs in the neonatal unit. Our objective was to assess associations between the duration of the initial antibiotic course and subsequent necrotizing enterocolitis (NEC) and/or death in very low birth weight (VLBW) neonates with sterile initial postnatal culture results.

Design and setting: A retrospective cohort analysis of VLBW neonates admitted to a tertiary center during the period from 1 January 2008 to 31 december 2009.

Patients and methods: The study included VLBW neonates who had been inborn and admitted to the neonatal intensive care unit within the first 24 hours after birth. We used descriptive statistics to characterize the study population, and multivariate analyses to evaluate associations between therapy duration, prolonged empirical therapy, and subsequent NEC and/or death.

Results: Of 328 VLBW neonates admitted to our center, 207 (63%) survived >5 days and received initial empirical antibiotic treatment for ≥5 days. The median duration of initial empirical antibiotic therapy was 7 days (range 5-10 days). those neonates were more likely to be of younger gestational age, lower birth weight, and to have lower Apgar scores (P<.001, .001 and .017, respectively). each empirical treatment day was associated with increased odds of death (or 1.45, CI 1.24-1.69), NEC (or 1.32, CI 1.05-1.65), and the composite measure of NEC or death (or 2.13, CI 1.55-2.93).

Conclusion: The use of prolonged initial empirical antibiotic therapy in VLBW neonates with initial sterile culture results may be associated with an increased risk of NEC or death and should be used with caution.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Numbers of study infants according to duration of initial empirical antibiotic treatment.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Stoll BJ, Hansen NI, Higgins RD, Fanaroff AA, Duara S, Goldberg R, et al. Very low birth weight preterm infants with early onset neonatal sepsis: the predominance of gram-negative infections continues in the National Institute of Child Health and Human Development Neonatal Research Network, 2002–2003. Pediatr Infect Dis J. 2005;24:635–9. - PubMed
    1. Kaufman D, Fairchild KD. Clinical microbiology of bacterial and fungal sepsis in very-lo w-birthweight infants. Clin Microbiol Rev. 2004;17:638–80. - PMC - PubMed
    1. Lopez Sastre JB, Fernandez Colomer B, Coto Cotallo GD, Ramos Aparicio A. Trends in the epidemiology of neonatal sepsis of vertical transmission in the era of group B streptococcal prevention. Acta Paediatr. 2005;94:451–7. - PubMed
    1. Clark RH, Bloom BT, Spitzer AR, Gerstmann DR. Empiric use of ampicillin and cefotaxime, compared with ampicillin and gentamicin, for neonates at risk for sepsis is associated with an increased risk of neonatal death. Pediatrics. 2006;117:67–74. - PubMed
    1. de Man P, Verhoeven BA, Verbrugh HA, Vos MC, van den Anker JN. An antibiotic policy to prevent emergence of resistant bacilli. Lancet. 2000;355:973–8. - PubMed

Substances