Association between early antibiotic exposure and bronchopulmonary dysplasia or death.

TitleAssociation between early antibiotic exposure and bronchopulmonary dysplasia or death.
Publication TypeJournal Article
Year of Publication2018
AuthorsFlannery DD, Dysart K, Cook A, Greenspan J, Aghai ZH, Jensen EA
JournalJ Perinatol
Date Published2018 Jun 13
ISSN1476-5543
Abstract

OBJECTIVE: To characterize the independent association between antibiotic exposure in the first week of life and the risk of bronchopulmonary dysplasia (BPD) or death among very preterm infants without culture-confirmed sepsis.

METHODS: Retrospective cohort study using the Optum Neonatal Database. Infants without culture-confirmed sepsis born less than 1500ā€‰g and less than 32 weeks gestation between 1/2010 and 11/2016 were included. The independent association between antibiotic therapy during the first week of life and BPD or death prior to 36 weeks postmenstrual age (PMA) was assessed by multivariable logistic regression.

RESULTS: Of 4950 infants, 3946 (79.7%) received antibiotics during the first week of life. Rates of BPD or death (41.5% vs. 31.1%, pā€‰<ā€‰0.001) and the two individual outcomes were significantly higher among antibiotic treated infants. After adjusting for potential confounding variables, antibiotic use in the first week of life was not associated with increased risk of BPD or death (OR 0.96, 95% CI [0.76,1.21]) or BPD among survivors (OR 0.86, 95% CI [0.67,1.09]). Antibiotic use was associated with increased risk of death prior to 36 weeks PMA (OR 3.01, 95% CI [1.59,5.71]), however, secondary analyses suggested this association may be confounded by unmeasured illness severity.

CONCLUSIONS: Antibiotic exposure in the first week of life among preterm infants without culture-confirmed sepsis was not independently associated with increased risk of BPD or death.

DOI10.1038/s41372-018-0146-3
Alternate JournalJ Perinatol
PubMed ID29895965
Grant ListT32 HD060550 / HD / NICHD NIH HHS / United States
T32HD060550 / / U.S. Department of Health & Human Services | NIH | Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) /