Marcus Wing Choy Loe, Rehena Sultana, Guan Lin Goh, Selina Wan Xuan Lim, Kee Thai Yeo
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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; <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><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; <i>p</i><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 >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, Rehena Sultana, Guan Lin Goh, Selina Wan Xuan Lim, 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 <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 >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><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; <i>p</i><0.01) for death and/or BPD. 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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。
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.
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