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Early Use of Antibiotics Is Associated with a Lower Incidence of Necrotizing Enterocolitis in Preterm, Very Low Birth Weight Infants: Neomune-NeoNutriNet Cohort Study

Space: StayCurrentMD Author: J Pediatr (Li Y, Shen RL, Ayede AI, Berrington J, Bloomfield FH, Busari OO, Cormack BE, Embleton ND, van Goudoever JB, Greisen G, He Z, Huang Y, Li X, Lin HC, Mei J, Meier PP, Nie C, Patel AL, Sangild PT, Skeath T, Simmer K, Uhlenfeldt S, de Waard M, Ye S Published:

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J Pediatr (Li Y, Shen RL, Ayede AI, Berrington J, Bloomfield FH, Busari OO, Cormack BE, Embleton ND, van Goudoever JB, Greisen G, He Z, Huang Y, Li X, Lin HC, Mei J, Meier PP, Nie C, Patel AL, Sangild PT, Skeath T, Simmer K, Uhlenfeldt S, de Waard M, Ye S

Topic overview

Objective: To determine whether commencement of antibiotics within 3 postnatal days in preterm, very low birth weight infants (VLBW, ≤1500 g), is associated with the development of necrotizing enterocolitis (NEC).

Study design: Pre-planned statistical analyses were done to study the association between early antibiotic treatment and later NEC development, using the NEOMUNE-NeoNutriNet cohort of VLBW infants from 13 neonatal intensive care units (NICUs) in five continents (n=2831). NEC incidence was compared between infants who received early antibiotics and those who did not, with statistical adjustments for NICU, gestational age, birth weight, sex, delivery mode, antenatal steroids, Apgar score, and type and initiation of enteral nutrition.

Results: The incidence of NEC was 9.0% in the group of infants who did not receive early antibiotics (n=269) versus 3.9% in the remaining infants (n=2562). NEC incidence remained lower in the early-antibiotic group after stepwise statistical adjustments for NICU (OR 0.57; 95% CI, 0.35-0.94, P < .05) and other potential confounders (OR 0.25; CI, 0.12-0.47, P

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