ArticleItalian journal of pediatrics2023
The impact of early empirical antibiotics treatment on clinical outcome of very preterm infants: a nationwide multicentre study in China.
Article in Italian journal of pediatrics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed, 7 citations in OpenAlex.
- Antimicrobial-associated adverse events in neonates: an integrated literature review and FAERS pharmacovigilance analysis.Naunyn-Schmiedeberg's archives of pharmacology · 2026Review
- Bifidobacterium modulates gut microbiota and aryl hydrocarbon receptor signaling in necrotizing enterocolitis rat model.Pediatric research · 2026Article
- A nomogram to predict bronchopulmonary dysplasia in very preterm and/or very low birth weight infants with early-onset sepsis.BMC pediatrics · 2026Observational
- Association Between Serum Caffeine Concentrations, Intermittent Hypoxia and Apnea in Preterm Infants: A Prospective Observational Study.Children (Basel, Switzerland) · 2026Article
- The Gut Resistome Atlas in Preterm Infants Enables Prediction of Necrotizing Enterocolitis Onset.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Article
- The double-edged sword of early antibiotic exposure in extremely preterm infants: implications for necrotizing enterocolitis and growth faltering.Pediatric research · 2025Article
- [A quality improvement project on reducing antibiotic use duration in very low birth weight preterm infants in the neonatal intensive care unit].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2024Article
- Nutritional Strategies for Preterm Neonates and Preterm Neonates Undergoing Surgery: New Insights for Practice and Wrong Beliefs to Uproot.Nutrients · 2024Review
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19 authors at 13 institutions in 1 country.
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Abstract
backgroundInfants with rule-out infections are responsible for the majority of empirical antibiotics treatment (EAT) in neonatal intensive care units (NICUs), particularly very preterm infants (VPIs). Antibiotic overuse has been linked to adverse outcomes. There is a paucity of data on the association between EAT and clinical outcomes (containing the nutritional outcomes) of VPIs without infection-related morbidities.
methodsClinical data of VPIs admitted in 28 hospitals in 20 provinces of China from September 2019 to December 2020 were collected. EAT of VPIs was calculated as the number of days with initial usage in the first week after birth, and then categorized into 3 groups (antibiotic exposure: none, 1-4 days, and > 4 days). Clinical characteristics, nutritional status , and the short-term clinical outcomes among 3 groups were compared and analyzed.
resultsIn total, 1834 VPIs without infection-related morbidities in the first postnatal week were enrolled, including 152 cases (8.3%) without antibiotics, 374 cases (20.4%) with EAT ≤4 days and 1308 cases (71.3%) with EAT > 4 days. After adjusting for the confounding variables, longer duration of EAT was associated with decreased weight growth velocity and increased duration of reach of full enteral feeding in EAT > 4 days group (aβ: -4.83, 95% CI: - 6.12 ~ - 3.53; aβ: 2.77, 95% CI: 0.25 ~ 5.87, respectively) than those receiving no antibiotics. In addition, the risk of feeding intolerance (FI) in EAT > 4 days group was 4 times higher than that in non-antibiotic group (aOR: 4.14, 95%CI: 1.49 ~ 13.56) and 1.8 times higher than that in EAT ≤4 days group (aOR: 1.82, 95%CI: 1.08 ~ 3.17). EAT > 4 days was also a risk factor for greater than or equal to stage 2 necrotizing enterocolitis (NEC) than those who did not receive antibiotics (aOR: 7.68, 95%CI: 1.14 ~ 54.75) and those who received EAT ≤4 days antibiotics (aOR: 5.42, 95%CI: 1.94 ~ 14.80).
conclusionsThe EAT rate among uninfected VPIs was high in Chinese NICUs. Prolonged antibiotic exposure was associated with decreased weight growth velocity, longer duration of reach of full enteral feeding, increased risk of feeding intolerance and NEC ≥ stage 2. Future stewardship interventions to reduce EAT use should be designed and implemented.
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