Prolonged duration of early antibiotic therapy in extremely premature infants.

TitleProlonged duration of early antibiotic therapy in extremely premature infants.
Publication TypeJournal Article
Year of Publication2019
AuthorsGreenberg RG, Chowdhury D, Hansen NI, P Smith B, Stoll BJ, Sanchez PJ, Das A, Puopolo KM, Mukhopadhyay S, Higgins RD, C Cotten M
Corporate AuthorsEunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
JournalPediatr Res
Date Published2019 Jan 22
ISSN1530-0447
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.

DOI10.1038/s41390-019-0300-4
Alternate JournalPediatr. Res.
PubMed ID30737489