ArticleArchives of disease in childhood. Fetal and neonatal edition2023
Early initiation of antibiotic therapy and short-term outcomes in preterm infants: a single-centre retrospective cohort analysis.
Article in Archives of disease in childhood. Fetal and neonatal edition, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Pediatric stewardship in Italy: a necessity, not an option - a National Multi-Society Expert Consensus on Antimicrobial and Diagnostic Stewardship (SIP, SITIP, SIMRI, SIAIP, SIMEUP, SIPPS, SICUPP, SIMIT, SIMPE, SIPINF, SIT, SIAATIP, SARNEPI, AIEOP, SIM, SITI, SIF, SIFACT, SITA, SIN).Italian journal of pediatrics · 2025Pooled it
- Effect of early antibiotic exposure on necrotizing enterocolitis and growth in extremely preterm infants.Pediatric research · 2025Trial
- The Goldilocks zone of optimal antimicrobial stewardship in preterm infants.Pediatric research · 2026Article
- Antimicrobial-associated adverse events in neonates: an integrated literature review and FAERS pharmacovigilance analysis.Naunyn-Schmiedeberg's archives of pharmacology · 2026Review
- The hidden cost of antibiotics: microbial dysbiosis-induced SCFA imbalance and its underlying mechanisms.Frontiers in immunology · 2026Review
- Dynamics of postnatal upper airway bacteria colonization in preterm infants <1000g and bronchopulmonary dysplasia.Scientific reports · 2025Article
- Neonatology: First Exposure to Antibiotics from the Ethical Perspective of Parents, Physicians, and Regulators.Antibiotics (Basel, Switzerland) · 2025Article
- Atypical Presentation of Cat-Scratch Disease in a 30-Year-Old Female: A Case Study.Clinical case reports · 2025Article
- The double-edged sword of early antibiotic exposure in extremely preterm infants: implications for necrotizing enterocolitis and growth faltering.Pediatric research · 2025Article
- Absence of association between early antibiotic exposure and short-term adverse outcomes in very preterm infants: a single-center retrospective study.Frontiers in pediatrics · 2025Article
- 28 NICUs participating in a quality improvement collaborative targeting early-onset sepsis antibiotic use.Journal of perinatology : official journal of the California Perinatal Association · 2024Article
- Sustaining the Continued Effectiveness of an Antimicrobial Stewardship Program in Preterm Infants.Tropical medicine and infectious disease · 2024Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSepsis is one of the most important complications in preterm infants. For this reason, many such infants receive antibiotics during their hospital stay. However, early antibiotic therapy has also been associated with adverse outcome. It is yet largely unclear if the time of onset of antibiotic therapy influences the outcome. We here investigated whether the timing of initiation of antibiotic therapy plays a role in the association between antibiotic exposure and short-term outcome.
methodsRetrospective analysis of data from 1762 very low birthweight infants born in a German neonatal intensive care unit (NICU) between January 2004 and December 2021.
resultsAntibiotics were administered to 1214 of the 1762 (68.9%) infants. In 973 (55.2%) of the 1762 of infants, antibiotic therapy was initiated within the first two postnatal days. Only 548 (31.1%) infants did not have any antibiotic prescription during their stay in the NICU. Antibiotic exposure at every timepoint was associated with an increased risk of all short-term outcomes analysed in univariable analyses. In multivariable analyses, initiation of antibiotic therapy within the first two postnatal days and initiation between postnatal days 3 and 6 was independently associated with an increased risk of developing bronchopulmonary dysplasia (BPD) (OR 3.1 and 2.8), while later initiation of antibiotic therapy was not.
conclusionVery early initiation of antibiotic therapy was associated with an increased risk of BPD. Due to the study design, no conclusions on causality can be drawn. If confirmed, our data suggest that an improved identification of infants at low risk of early-onset sepsis is needed to reduce antibiotic exposure.
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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.