Increased antibiotic exposure in early life is associated with adverse outcomes in very low birth weight infants
Increased antibiotic exposure in early life is associated with adverse outcomes in very low birth weight infants
复制标题
DOI：
10.1097/jcma.0000000000000749
复制
发表时间：
2022-09-01
影响因子：
3
通讯作者：
Hung, Miao-Chiu
中科院分区：
文献类型：
--
作者：
Chen, Wen-Yin;Lo, Yu-Cheng;Hung, Miao-Chiu
背景：在早产儿早期使用抗生素可能会改变其微生物群并影响其临床结果。然而，益生菌的使用是否会影响这些结果仍然未知。在我们的研究中，除非有禁忌症，否则益生菌是常规使用的。我们探讨了常规使用益生菌增加抗生素暴露是否与坏死性小肠结肠炎（NEC）或支气管肺发育不良（BPD）有关。方法：采用回顾性队列研究，纳入2016年1月1日至2020年3月31日在某医疗中心住院的极低出生体重（VLBW）婴儿。记录出生后14天的抗生素暴露天数。主要结果为NEC和BPD。采用多变量回归分析计算校正优势比（aORs）和95%置信区间（CIs），以评估危险因素。结果：185例VLBW患儿中，132例符合纳入标准。每增加一天的抗生素治疗与NEC （aOR, 1.278; 95% CI, 1.025-1.593）和BPD （aOR, 1.630; 95% CI, 1.233-2.156）的几率增加相关。在调整益生菌使用后，NEC分析中仍然存在这种关联。结论：VLBW婴儿早期抗生素暴露增加与NEC和BPD风险增加相关。益生菌对结果没有影响。我们的研究结果表明，临床医生应该警惕VLBWs婴儿使用抗生素的不良后果。
Background: The use of antibiotics in the early lives of premature infants may alter the microbiota and influence their clinical outcomes. However, whether the administration of probiotics can influence these outcomes remains unknown. In our study, probiotics were routinely administered unless contraindicated. We explored whether increased antibiotic exposure with the routine use of probiotics was associated with necrotizing enterocolitis (NEC) or bronchopulmonary dysplasia (BPD). Methods: A retrospective cohort study was conducted, enrolling very low birth weight (VLBW) infants admitted between January 1, 2016, and March 31, 2020, to a medical center. Days of antibiotic exposure in the first 14 days of life were recorded. The primary outcomes were NEC and BPD. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated using multivariable regression analyses to assess risk factors. Results: Of 185 VLBW infants admitted to the medical center, 132 met the inclusion criteria. Each additional day of antibiotic treatment was associated with increased odds of NEC (aOR, 1.278; 95% CI, 1.025-1.593) and BPD (aOR, 1.630; 95% CI, 1.233-2.156). The association remained in the NEC analysis after adjustment for probiotic use. Conclusion: Increased antibiotic exposure in the early lives of VLBW infants was associated with increased risks of NEC and BPD. The probiotics did not influence the outcomes. Our findings suggest that clinicians should be alerted to the adverse outcomes of antibiotic use in infants with VLBWs.