Prolonged exposure to antibiotics and its associations in extremely preterm neonates - the Western Australian experience. (November 2013)

• Record Type: Journal Article
• Authors: Shah, P.; Nathan, E.; Doherty, D.; Patole, S.
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 26:Number 17(2013)
• Page Start: 1710
• Page End: 1714
• Publication Date: 2013-11
• Subjects: Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.3109/14767058.2013.791274
• Languages: English
• ISSNs: 1476-7058

Abstract

<abstract> <title>Abstract</title> <p> <italic>Background</italic>: Prolonged exposure to antibiotics (PEA) is associated with increased risk of necrotising enterocolitis (NEC), late onset sepsis (LOS) and death in preterm neonates.</p> <p> <italic>Aim:</italic> To evaluate PEA (≥4 d) for suspected (blood culture negative) sepsis and its association with NEC, LOS and death in extremely preterm (EP: Gestation &lt;28 weeks) neonates.</p> <p> <italic>Methods</italic>: Data on demographic characteristics, antibiotic exposure for early onset sepsis (EOS) or LOS and outcomes to discharge/death were collected for 216 EP neonates admitted between 1/1/2009 and 31/12/2010.</p> <p> <italic>Results</italic>: All 216 neonates received antibiotics for suspected EOS; 120/216 (56%) had PEA. 137/216 who survived first 72 h of life, had suspected LOS [range 1–8 episodes], treated with antibiotics for median (IQR) duration of 8 (5–14) days. 89/216 had proven (blood culture positive) LOS [range 1–3 episodes], treated with antibiotics for median (IQR) duration of 10 (7–18) days. The incidence of and death due to ≥Stage II NEC was 17/216 (7.8%) and 5/17 (29.4%) respectively. PEA for suspected EOS was associated with proven LOS (OR: 2.1, 95% CI: 1.2–3.7, <italic>p</italic> = 0.013) after adjusting for gestation and IUGR, but not with NEC/death.</p> <p> <italic>Conclusion</italic>: PEA for ≥4 d for suspected EOS was associated with increased odds for proven LOS.</p> </abstract>