Home Print this page Email this page Small font sizeDefault font sizeIncrease font size
Users Online: 372
About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Advertise Login 
Year : 2018  |  Volume : 7  |  Issue : 3  |  Page : 116-120

Does prolonged initial empirical antibiotics treatment increase morbidity and mortality in preterm infants <34 weeks?

NICU Department, East Jeddah Hospital, Al Sulimanyyah District, Jeddah, Kingdom of Saudi Arabia

Correspondence Address:
Dr. Tariq Rushdi Alsafadi
Neonatologist Consultant, East Jeddah Hospital, Jeddah
Kingdom of Saudi Arabia
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcn.JCN_86_17

Rights and Permissions

Background: Antibiotics are commonly used in the early postnatal period in preterm infants; its overuse can affect gut colonization and increased the risk of invasive infection. Aims: This study aims to determine whether the prolonged initial empirical antibiotic treatment (PIEAT) increased the risk of necrotizing enterocolitis (NEC), late-onset sepsis (LOS), and death in preterm infants <34 weeks. The secondary study objective was to reveal if severity of illness and sepsis laboratory tests were potential causes for PIEAT. Design: The study was a retrospective study. Setting: This study was conducted at three Neonatal Intensive Care Units (NICUs). Materials and Methods: NICUs medical records from January 2013 to March 2017. Inclusion criteria: (1) preterm infants < 34 weeks, (2) antibiotics started in the 1st postnatal day, (3) negative initial blood culture, (4) patients survived ≥5 days, (5) patients free of NEC in the first 4 postnatal days, and (6) patients without major congenital anomalies. Statistical Analysis: Logistic regression analysis. Results: Five hundred and eighty-seven neonates were eligible. Mean gestational age ± standard deviation (SD): 31.1 ± 2.8 weeks. Mean birth weight ± SD: 1440 ± 380 g. Mean of the duration of initial empirical antibiotic treatment ± SD: 7 ± 3.6 days. PIEAT increased the risk of NEC (odds ratio [OR]: 1.11, confidence interval [CI]: 1.011—1.219), and LOS (OR: 1.133 CI: 1.027—1.251). PIEAT did not significantly increase mortality (OR: 1.083 CI: 0.82—1.42). Sepsis laboratory tests that predicted PIEAT were abnormal leukocytes counts (OR: 1.078 CI: 1.012—1.167) and positive C-reactive protein (CRP) (OR: 1.15 CI: 1.036—1.277). The indicators of severity of illness, high-frequency oscillation ventilation (OR: 0.956 CI.826—1.106), and inotrope use (OR: 1.108 CI: 0.95—1.22) did not predict PIEAT. Conclusion: PIEAT ≥4 days for suspected early-onset sepsis with negative initial blood culture increased the risk of NEC and LOS in preterm infants < 34 weeks. Abnormal white blood cell count, thrombocytopenia, and positive CRP in the first 4 days with negative initial blood culture were potential causes of PIEAT.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded570    
    Comments [Add]    
    Cited by others 2    

Recommend this journal