Prolonged Antibiotic Use in Very Preterm Infants Linked to Increased Mortality Risk: JAMA

The key findings of this study were:

• Of the 27,176 VPIs included in the CHNN throughout the research period, a total of 6510 were classed as low risk for EOS.
• Among them, 1324 (20.3%) faced no antibiotic exposure, 1134 (17.4%) had 1 to 4 days of antibiotic treatment and 4052 (62.2%) received 5 to 7 days of antibiotic therapy.
• Of the 5186 VPIs who got antibiotics, 4098 (79.0%) infants got broad-spectrum antibiotics, 888 (17.1%) infants got narrow-spectrum antibiotics and 200 (3.9%) infants were given antifungals or other antibiotics.
• Prolonged exposure (5-7 days) was related with an increased risk of moderate to severe BPD or mortality. The use of broad-spectrum antibiotics (1-7 days) was also linked to an elevated risk of moderate to severe BPD and mortality.

Overall, this analysis of VPIs at low risk for EOS, extended or broad-spectrum antibiotic use was linked to an elevated chance of acquiring moderate to severe BPD or mortality. These findings indicate that VPIs who were exposed to extended or broad-spectrum antibiotics early in infancy should be monitored for the potential complications.

Source:

Shi, W., Chen, Z., Shi, L., Jiang, S., Zhou, J., Gu, X., Lei, X., Xiao, T., Zhu, Y., Qian, A., Zhou, W., Lee, S. K., Du, L., Yang, J., Ma, X., Hu, L., Chen, C., Cao, Y., … Chen, X. (2024). Early Antibiotic Exposure and Bronchopulmonary Dysplasia in Very Preterm Infants at Low Risk of Early-Onset Sepsis. In JAMA Network Open (Vol. 7, Issue 6, p. e2418831). American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2024.18831