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Prolonged Initial Empirical Antibiotic Treatment is Associated with Adverse Outcomes in Premature Infants

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Kuppala, Venkata S., Meinzen-Derr, Jareen, Morrow, Ardythe L., Schibler, Kurt R.·2011·The Journal of Pediatrics

Abstract

Objective To investigate the outcomes following prolonged empirical antibiotic administration to premature infants in the first week of life, concluding subsequent late onset sepsis (LOS), necrotizing enterocolitis (NEC), and death. Study design Study infants were ≤32 weeks gestational age and ≤ 1500 grams birth weight who survived free of sepsis and NEC for 7 days. Multivariable logistic regression was conducted to determine independent relationships between prolonged initial empirical antibiotic therapy (≥ 5 days) and study outcomes controlling for birth weight, gestational age, race, prolonged premature rupture of membranes, days on high frequency ventilation in 7 days, and the amount of breast milk received in the first 14 days of life. Results Of the 365 premature infants surviving 7 days free of sepsis or NEC, 36% received prolonged initial empirical antibiotics, which was independently associated with subsequent outcomes: LOS (odds ratio [OR] 2.45, 95% confidence interval [CI] 1.28–4.67) and the combination of LOS, NEC, or death (OR 2.66, 95% CI 1.12–6.3). Conclusions Prolonged administration of empirical antibiotics to premature infants with sterile cultures in the first week of life is associated with subsequent severe outcomes. Judicious restriction of antibiotic use should be investigated as a strategy to reduce severe outcomes for premature infants.

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Crossref · 10.1016/j.jpeds.2011.05.033

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Metadata

Authors
Kuppala, V. S., Meinzen-Derr, J., Morrow, A. L., & Schibler, K. R.
Venue
The Journal of Pediatrics
Publisher
Elsevier BV
Published
2011-11
Volume
159
Issue
5
Pages
720-725
ISSN
0022-3476 (ISSN-L)
OpenAlex
W1978213978
Cited by
613
References
6
FWCI
24.99
Type
journal article
Language
en
Open access
green

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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