Observational studyArchives of disease in childhood. Fetal and neonatal edition2025
Antibiotic use among extremely low birth-weight infants from 2009 to 2021: a retrospective observational study.
Observational study in Archives of disease in childhood. Fetal and neonatal edition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Utility of biomarkers in VLBW sepsis evaluations: the implementation gap.Pediatric research · 2026Article
- Association between initial empirical antibiotic therapy and necrotizing enterocolitis in very preterm infants at different risk for early-onset sepsis: a multicenter cohort study.BMC pregnancy and childbirth · 2026Observational
- Institutional Practices Drive Antibiotic Variability in Neonatal Intensive Care Units: Baseline Evidence to Inform National Stewardship Interventions in Oman.Antibiotics (Basel, Switzerland) · 2026Article
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Authors and funding
9 authors.
Funding
Abstract
objectiveTo assess trends in antibiotic use across a large cohort of extremely low birth-weight (<1000 g; ELBW) infants admitted to academic and community neonatal intensive care units (NICUs) across the USA over a 13-year period.
designRepeated cross-sectional cohort study.
settingPremier Health Database, a comprehensive administrative database of inpatient encounters from academic and community hospitals across the US. PATIENTS: ELBW inborn infants admitted to NICUs from 1 January 2009 to 31 December 2021.
interventionsN/A
main outcome measuresAbsolute and relative changes in (1) proportion of ELBW infants with antibiotic exposure and (2) days of therapy (DOT) per 1000 patient days, over time. Average annual differences were estimated using generalised linear regression with 95% CI. Disposition trends were also measured.
resultsAmong 36 701 infants admitted to 402 NICUs, the proportion exposed to antibiotics was essentially unchanged (89.9% in 2009 to 89.3% in 2021; absolute reduction of -0.6%); generalised linear regression estimated an annual absolute difference of -0.3% (95% CI (-0.6%) to (-0.07%); p=0.01). DOT per 1000 patient days decreased from 337 in 2009 to 210 in 2021, a 37.8% relative difference and annual relative difference of -4.3% ((-5.2%) to (-3.5%); p<0.001). Mortality was unchanged during the study period.
conclusionsWe found a substantial reduction in antibiotic DOT despite no substantive change in the proportion of infants exposed to antibiotics. This suggests the success of stewardship efforts aimed at antibiotic duration and highlight the need for improved approaches to identifying ELBW infants at highest risk of infection.
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