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Minerva Pediatrica 2019 Nov 11

DOI: 10.23736/S0026-4946.19.05640-8

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Early initiation of broad-spectrum antibiotics in premature infants

Suzan ASFOUR, Mountasser AL-MOUQDAD

NICU Department, King Saud Medical City, Pediatric Hospital, Riyadh, Saudi Arabia


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BACKGROUND: Neonatal sepsis remains one of the main reasons for mortality among premature infants, and the early initiation of empirical broad-spectrum antibiotics could increase the risk of complications, including late-onset sepsis. This study aimed to investigate the complications related to the use of empirical broad-spectrum antibiotics in the first week of life.
METHODS: A retrospective study of 365 neonates with gestational age ≤32 weeks and birth weight <1,500 g who survived and had no confirmed sepsis in the first week of life from July 2015 to June 2018 was performed in a large tertiary neonatal intensive care unit. The primary outcome of this study was the incidence of a composite outcome consisting of late-onset sepsis, necrotizing enterocolitis, and mortality. The secondary outcomes were the incidences of late-onset sepsis, necrotizing enterocolitis, bronchopulmonary dysplasia, and infant mortality.
RESULTS: Of the 365 premature infants, 75 (20.5%) received broad-spectrum antibiotics. Multivariate regression analysis revealed that administration of broad-spectrum antibiotics in infants was independently associated with adverse outcomes. The composite outcome (late- onset sepsis, necrotizing enterocolitis, and death) had an odds ratio of 3.03 with 95% confidence interval of 1.41-6.49.
CONCLUSIONS: Administration of empirical broad-spectrum antibiotics in the first week of life is associated with severe adverse outcomes. Thus, the restricted use of broad-spectrum antibiotics in the first week of life is recommended.


KEY WORDS: Intensive care unit; Neonatal sepsis; Mortality

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