抗生素使用时间和类型对极低出生体重儿短期和长期预后的影响。

IF 2.4 4区 医学 Q1 PEDIATRICS
Acta Paediatrica Pub Date : 2024-11-19 DOI:10.1111/apa.17509
Marcus Wing Choy Loe, Rehena Sultana, Guan Lin Goh, Selina Wan Xuan Lim, Kee Thai Yeo
{"title":"抗生素使用时间和类型对极低出生体重儿短期和长期预后的影响。","authors":"Marcus Wing Choy Loe,&nbsp;Rehena Sultana,&nbsp;Guan Lin Goh,&nbsp;Selina Wan Xuan Lim,&nbsp;Kee Thai Yeo","doi":"10.1111/apa.17509","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aim</h3>\n \n <p>To determine the association between the duration and types of antibiotic exposure and the occurrence of short- and long-term outcomes among preterm, very-low-birthweight (VLBW) infants.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Retrospective cohort study of VLBW infants born &lt;32 weeks gestation between January 2017–December 2021. Association between antibiotic exposure and the occurrence of death and/or major morbidities, and neurodevelopmental impairment (NDI) at 18–24 months corrected age, was evaluated.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 728 infants were included—median gestation 28 weeks (IQR 26, 30) and median birthweight 1070g (IQR 850, 1300). Compared to no antibiotics, antibiotics exposure &gt;3 days was significantly associated with increased risk of mortality and/or bronchopulmonary dysplasia (BPD)—adjusted odds ratio (AOR) 2.0 (95% CI 1.1–3.8; <i>p</i>=0.03), 3.5 (95% CI 1.6–7.8; <i>p</i>=0.01) and 3.8 (95% CI 1.6-9.0; <i>p</i>&lt;0.001) corresponding to antibiotic exposure of 4-7 days, 8–14 and &gt;14 days, respectively. Additional exposure to broad-spectrum antibiotics was associated with AOR of 3.2 (95% CI 1.6–6.5; <i>p</i>&lt;0.01) for death and/or BPD. There was no significant association between antibiotic exposure and NDI.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Infants who received &gt;3 days of antibiotics and/or additional broad-spectrum antibiotics had significantly increased odds of death and/or BPD compared to no exposure. Antibiotic exposure was not significantly associated with NDI in our population.</p>\n </section>\n </div>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"114 5","pages":"936-943"},"PeriodicalIF":2.4000,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of antibiotic duration and type on short- and long-term outcomes in very-low-birthweight infants\",\"authors\":\"Marcus Wing Choy Loe,&nbsp;Rehena Sultana,&nbsp;Guan Lin Goh,&nbsp;Selina Wan Xuan Lim,&nbsp;Kee Thai Yeo\",\"doi\":\"10.1111/apa.17509\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Aim</h3>\\n \\n <p>To determine the association between the duration and types of antibiotic exposure and the occurrence of short- and long-term outcomes among preterm, very-low-birthweight (VLBW) infants.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Retrospective cohort study of VLBW infants born &lt;32 weeks gestation between January 2017–December 2021. Association between antibiotic exposure and the occurrence of death and/or major morbidities, and neurodevelopmental impairment (NDI) at 18–24 months corrected age, was evaluated.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>A total of 728 infants were included—median gestation 28 weeks (IQR 26, 30) and median birthweight 1070g (IQR 850, 1300). Compared to no antibiotics, antibiotics exposure &gt;3 days was significantly associated with increased risk of mortality and/or bronchopulmonary dysplasia (BPD)—adjusted odds ratio (AOR) 2.0 (95% CI 1.1–3.8; <i>p</i>=0.03), 3.5 (95% CI 1.6–7.8; <i>p</i>=0.01) and 3.8 (95% CI 1.6-9.0; <i>p</i>&lt;0.001) corresponding to antibiotic exposure of 4-7 days, 8–14 and &gt;14 days, respectively. Additional exposure to broad-spectrum antibiotics was associated with AOR of 3.2 (95% CI 1.6–6.5; <i>p</i>&lt;0.01) for death and/or BPD. There was no significant association between antibiotic exposure and NDI.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>Infants who received &gt;3 days of antibiotics and/or additional broad-spectrum antibiotics had significantly increased odds of death and/or BPD compared to no exposure. Antibiotic exposure was not significantly associated with NDI in our population.</p>\\n </section>\\n </div>\",\"PeriodicalId\":55562,\"journal\":{\"name\":\"Acta Paediatrica\",\"volume\":\"114 5\",\"pages\":\"936-943\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2024-11-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta Paediatrica\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/apa.17509\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Paediatrica","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/apa.17509","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0

摘要

目的:确定早产超低体重儿(VLBW)接触抗生素的时间和类型与短期和长期结果之间的关系:方法:对超低体重儿进行回顾性队列研究:共纳入 728 名婴儿--中位妊娠期为 28 周(IQR 为 26-30 周),中位出生体重为 1070 克(IQR 为 850-1300 克)。与不使用抗生素相比,接触抗生素超过 3 天与死亡率和/或支气管肺发育不良(BPD)风险增加显著相关--调整后的几率比(AOR)分别为 2.0(95% CI 1.1-3.8;p=0.03)、3.5(95% CI 1.6-7.8;p=0.01)和 3.8(95% CI 1.6-9.0;p14 天)。额外接触广谱抗生素与 3.2(95% CI 1.6-6.5;p)的 AOR 有关:与未接触抗生素的婴儿相比,接触抗生素超过 3 天和/或额外接触广谱抗生素的婴儿死亡和/或 BPD 的几率显著增加。在我们的人群中,抗生素暴露与NDI无明显关联。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of antibiotic duration and type on short- and long-term outcomes in very-low-birthweight infants

Aim

To determine the association between the duration and types of antibiotic exposure and the occurrence of short- and long-term outcomes among preterm, very-low-birthweight (VLBW) infants.

Methods

Retrospective cohort study of VLBW infants born <32 weeks gestation between January 2017–December 2021. Association between antibiotic exposure and the occurrence of death and/or major morbidities, and neurodevelopmental impairment (NDI) at 18–24 months corrected age, was evaluated.

Results

A total of 728 infants were included—median gestation 28 weeks (IQR 26, 30) and median birthweight 1070g (IQR 850, 1300). Compared to no antibiotics, antibiotics exposure >3 days was significantly associated with increased risk of mortality and/or bronchopulmonary dysplasia (BPD)—adjusted odds ratio (AOR) 2.0 (95% CI 1.1–3.8; p=0.03), 3.5 (95% CI 1.6–7.8; p=0.01) and 3.8 (95% CI 1.6-9.0; p<0.001) corresponding to antibiotic exposure of 4-7 days, 8–14 and >14 days, respectively. Additional exposure to broad-spectrum antibiotics was associated with AOR of 3.2 (95% CI 1.6–6.5; p<0.01) for death and/or BPD. There was no significant association between antibiotic exposure and NDI.

Conclusion

Infants who received >3 days of antibiotics and/or additional broad-spectrum antibiotics had significantly increased odds of death and/or BPD compared to no exposure. Antibiotic exposure was not significantly associated with NDI in our population.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Acta Paediatrica
Acta Paediatrica 医学-小儿科
CiteScore
6.50
自引率
5.30%
发文量
384
审稿时长
2-4 weeks
期刊介绍: Acta Paediatrica is a peer-reviewed monthly journal at the forefront of international pediatric research. It covers both clinical and experimental research in all areas of pediatrics including: neonatal medicine developmental medicine adolescent medicine child health and environment psychosomatic pediatrics child health in developing countries
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信