ArticleAnnals of Saudi medicine
Empirical antibiotic treatment and the risk of necrotizing enterocolitis and death in very low birth weight neonates.
Article in Annals of Saudi medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
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The trial behind it
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Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Association of initial empirical antibiotic therapy with increased risk of necrotizing enterocolitis.European journal of pediatrics · 2020Pooled it
- The initial prophylactic antibiotic usage and subsequent necrotizing enterocolitis in high-risk premature infants: a systematic review and meta-analysis.Pediatric surgery international · 2018Pooled it
- Effect of early antibiotic exposure on necrotizing enterocolitis and growth in extremely preterm infants.Pediatric research · 2025Trial
- Routine Early Antibiotic Use in SymptOmatic Preterm Neonates: A Pilot Randomized Controlled Trial.The Journal of pediatrics · 2021Trial
- Compact Gut Microbial Dysbiosis Signature Associated with Necrotizing Enterocolitis and Altered Early Microbiota Development.Pathogens (Basel, Switzerland) · 2026Article
- Early antibiotic exposure and necrotizing enterocolitis among preterm infants < 34 weeks' gestation.Pediatric research · 2025Article
- Frequency and types of antibiotic usage in a referral neonatal intensive care unit, based on the world health organization classification (AwaRe).BMC pediatrics · 2025Article
- A Multi-Center Survey of Necrotizing Enterocolitis Prevention Strategies in Very Low Birth Weight Infants.Pediatric health, medicine and therapeutics · 2025Article
- The clinical characteristics and risk factors analysis within one week before the onset of necrotizing enterocolitis.Scientific reports · 2024Article
- Prevention Strategies and Management of Necrotizing Enterocolitis.Current treatment options in pediatrics · 2024Article
- Assessing Diagnostic Performance of Molecular Culture for Neonatal Sepsis: Protocol of the CHAMPIONS Study.Diagnostics (Basel, Switzerland) · 2024Article
- Umbilical arterial catheter duration as risk factor for Bell's Stage III necrotizing enterocolitis in preterm neonates.JPGN reports · 2024Article
- Pattern of Inflammatory Markers and Use of Antibiotics in Meconium Aspiration Syndrome: A Retrospective Cohort Study.Cureus · 2023Article
- The Detrimental Effects of Peripartum Antibiotics on Gut Proliferation and Formula Feeding Injury in Neonatal Mice Are Alleviated withMicroorganisms · 2023Article
- Early antibiotics and risk for necrotizing enterocolitis in premature infants: A narrative review.Frontiers in pediatrics · 2023Review
- Necrotizing enterocolitis following treatment of congenital syphilis with penicillin in a term newborn.SAGE open medical case reports · 2023Article
- Fetal-neonatal exposure to antibiotics and NEC development: A systematic review and meta-analysis.Frontiers in pediatrics · 2022Review
- Infection control and other stewardship strategies in late onset sepsis, necrotizing enterocolitis, and localized infection in the neonatal intensive care unit.Seminars in perinatology · 2020Article
- Preterm neonatal immunology at the intestinal interface.Cellular and molecular life sciences : CMLS · 2020Review
- Intestinal dysbiosis and necrotizing enterocolitis: assessment for causality using Bradford Hill criteria.Pediatric research · 2020Review
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesAntibiotics are one of the most overused drugs in the neonatal unit. Our objective was to assess associations between the duration of the initial antibiotic course and subsequent necrotizing enterocolitis (NEC) and/or death in very low birth weight (VLBW) neonates with sterile initial postnatal culture results. DESIGN AND
settingA retrospective cohort analysis of VLBW neonates admitted to a tertiary center during the period from 1 January 2008 to 31 december 2009. PATIENTS AND
methodsThe study included VLBW neonates who had been inborn and admitted to the neonatal intensive care unit within the first 24 hours after birth. We used descriptive statistics to characterize the study population, and multivariate analyses to evaluate associations between therapy duration, prolonged empirical therapy, and subsequent NEC and/or death.
resultsOf 328 VLBW neonates admitted to our center, 207 (63%) survived >5 days and received initial empirical antibiotic treatment for ≥5 days. The median duration of initial empirical antibiotic therapy was 7 days (range 5-10 days). those neonates were more likely to be of younger gestational age, lower birth weight, and to have lower Apgar scores (P<.001, .001 and .017, respectively). each empirical treatment day was associated with increased odds of death (or 1.45, CI 1.24-1.69), NEC (or 1.32, CI 1.05-1.65), and the composite measure of NEC or death (or 2.13, CI 1.55-2.93).
conclusionThe use of prolonged initial empirical antibiotic therapy in VLBW neonates with initial sterile culture results may be associated with an increased risk of NEC or death and should be used with caution.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.