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Multicenter Study
. 2019 Jun;85(7):994-1000.
doi: 10.1038/s41390-019-0300-4. Epub 2019 Jan 22.

Prolonged duration of early antibiotic therapy in extremely premature infants

Rachel G Greenberg  1 , Dhuly Chowdhury  2 , Nellie I Hansen  2 , P Brian Smith  3 , Barbara J Stoll  4 , Pablo J Sánchez  5 , Abhik Das  6 , Karen M Puopolo  7 , Sagori Mukhopadhyay  7 , Rosemary D Higgins  8 , C Michael Cotten  3 ; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
Affiliations
Multicenter Study

Prolonged duration of early antibiotic therapy in extremely premature infants

Rachel G Greenberg et al. Pediatr Res. 2019 Jun.

Abstract

Background: Prolonged early antibiotics in extremely premature infants may have negative effects. We aimed to assess prevalence and outcomes of provision of prolonged early antibiotics to extremely premature infants in the absence of culture-confirmed infection or NEC.

Methods: Cohort study of infants from 13 centers born without a major birth defect from 2008-2014 who were 401-1000 grams birth weight, 22-28 weeks gestation, and survived ≥5 days without culture-confirmed infection, NEC, or spontaneous intestinal perforation. We determined the proportion of infants who received prolonged early antibiotics, defined as ≥5 days of antibiotic therapy started at ≤72 h of age, by center and over time. Associations between prolonged early antibiotics and adverse outcomes were assessed using multivariable logistic regression.

Results: A total of 5730 infants were included. The proportion of infants receiving prolonged early antibiotics varied from 30-69% among centers and declined from 49% in 2008 to 35% in 2014. Prolonged early antibiotics was not significantly associated with death (adjusted odds ratio 1.17 [95% CI: 0.99-1.40], p = 0.07) and was not associated with NEC.

Conclusions: The proportion of extremely premature infants receiving prolonged early antibiotics decreased, but significant center variation persists. Prolonged early antibiotics were not significantly associated with increased odds of death or NEC.

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Figures

Figure 1.
Figure 1.
Percentage of study infants receiving prolonged early antibiotic therapy and percentage of infants with early-onset sepsis (EOS) by center.
See this image and copyright information in PMC

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References

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