Scholarlink

Background <p>To investigate whether use, duration, and types of early antibiotics were associated with the risk of necrotizing enterocolitis (NEC) among preterm infants born at &lt;34 weeks’ gestation.</p> Methods <p>This multicenter prospective cohort study included all infants with gestational age &lt;34 weeks and admitted to neonatal intensive care units across China. Early antibiotic exposure was defined as the antibiotic treatment initiated within the first three postnatal days. The short-term outcomes included death, NEC, death and/or NEC. Propensity score matching was performed to generate matched cohorts. The impacts of early antibiotics exposure on the outcomes were evaluated by univariate and multivariate logistic regression models.</p> Results <p>Among 24,926 eligible infants, 20164 (80.9%) received early antibiotics. After matching, early antibiotics exposure was not significantly associated with the death and/or NEC (adjusted OR, 0.93; 95%CI, 0.72–1.21), NEC (adjusted OR, 0.81; 95% CI, 0.60 –1.10) or death (adjusted OR, 1.42; 95% CI, 0.90–2.25). However, prolonged antibiotic treatment (adjusted OR, 2.95; 95% CI, 1.67–5.22), especially broad-spectrum antibiotics exposure (adjusted OR, 5.09; 95% CI, 1.84–14.10), was independently associated with death.</p> Conclusion <p>While early antibiotics exposure was not associated with the risks of NEC, prolonged antibiotic duration, especially broad-spectrum antibiotics, was associated with a higher mortality.</p> Impact <p><UnorderedList Mark="Bullet"> <ItemContent> <p>This multicenter cohort study sheds light on whether use, duration, and types of early antibiotics were associated with the risk of necrotizing enterocolitis among preterm infants &lt;34 weeks of gestation.</p> </ItemContent> <ItemContent> <p>In preterm infants, early antibiotics exposure was not significantly associated with the risks of death and/or NEC. However, prolonged antibiotic duration, especially broad-spectrum antibiotics, was associated with a higher mortality.</p> </ItemContent> <ItemContent> <p>Our study emphasizes the importance of neonatal antimicrobial stewardship in improving the prognosis of premature infants.</p> </ItemContent> </UnorderedList></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Early antibiotic exposure and necrotizing enterocolitis among preterm infants < 34 weeks’ gestation

  • 期刊论文

  • 发表日期：

    2025年5月8日

查看全文
  • Yue Zhu,
  • Shujuan Li,
  • Siyuan Jiang,
  • Weiyin Yu,
  • Yongfu Yu,
  • Zhenlang Lin,
  • Xiaoying Li,
  • Huiqing Sun,
  • Yan Mo,
  • Yihuang Huang,
  • Luyang Hong,
  • Joseph Y. Ting,
  • Shoo K. Lee,
  • Zhiping Li,
  • Weibing Wang,
  • Yun Cao

摘要

Background

To investigate whether use, duration, and types of early antibiotics were associated with the risk of necrotizing enterocolitis (NEC) among preterm infants born at <34 weeks’ gestation.

Methods

This multicenter prospective cohort study included all infants with gestational age <34 weeks and admitted to neonatal intensive care units across China. Early antibiotic exposure was defined as the antibiotic treatment initiated within the first three postnatal days. The short-term outcomes included death, NEC, death and/or NEC. Propensity score matching was performed to generate matched cohorts. The impacts of early antibiotics exposure on the outcomes were evaluated by univariate and multivariate logistic regression models.

Results

Among 24,926 eligible infants, 20164 (80.9%) received early antibiotics. After matching, early antibiotics exposure was not significantly associated with the death and/or NEC (adjusted OR, 0.93; 95%CI, 0.72–1.21), NEC (adjusted OR, 0.81; 95% CI, 0.60 –1.10) or death (adjusted OR, 1.42; 95% CI, 0.90–2.25). However, prolonged antibiotic treatment (adjusted OR, 2.95; 95% CI, 1.67–5.22), especially broad-spectrum antibiotics exposure (adjusted OR, 5.09; 95% CI, 1.84–14.10), was independently associated with death.

Conclusion

While early antibiotics exposure was not associated with the risks of NEC, prolonged antibiotic duration, especially broad-spectrum antibiotics, was associated with a higher mortality.

Impact

This multicenter cohort study sheds light on whether use, duration, and types of early antibiotics were associated with the risk of necrotizing enterocolitis among preterm infants <34 weeks of gestation.

In preterm infants, early antibiotics exposure was not significantly associated with the risks of death and/or NEC. However, prolonged antibiotic duration, especially broad-spectrum antibiotics, was associated with a higher mortality.

Our study emphasizes the importance of neonatal antimicrobial stewardship in improving the prognosis of premature infants.