JAMA Netw Open

Does early antibiotic exposure in preemies increase risk of BPD, death?

July 4, 2024

Exposure to prolonged or broad-spectrum antibiotics was associated with increased risk of developing moderate to severe bronchopulmonary dysplasia (BPD) or mortality. These findings suggest that very preterm infants (VPIs) exposed to prolonged or broad-spectrum antibiotics early in life should be monitored for adverse outcomes.

• This national multicenter cohort study utilized data from the Chinese Neonatal Network (CHNN) to evaluate the association of varying durations and types of early antibiotic exposure with the incidence of BPD in VPIs at low risk of early-onset sepsis (EOS). Primary outcome was the composite of moderate to severe BPD or mortality at 36 weeks' post menstrual age.
• Of the 27,176 VPIs (54.7% male), 23.9% were categorized as low risk for EOS. Among them, 20.3% had no antibiotic exposure, 17.4% received 1 to 4 days of antibiotics treatment, and 62.2% received 5 to 7 days of antibiotics treatment.
• Of the 5,186 VPIs who received antibiotics, 79% received broad-spectrum antibiotics, 17.1% received narrow-spectrum antibiotics, and 3.9% received antifungals or other antibiotics.
• Prolonged exposure (5-7 days) was associated with increased likelihood of moderate to severe BPD or death (adjusted odds ratio [aOR], 1.23). The use of broad-spectrum antibiotics (1-7 days) was also associated with a higher risk of moderate to severe BPD or death (aOR, 1.27).

Source:

Shi W, et al; Chinese Neonatal Network. (2024, June 3). JAMA Netw Open. Early Antibiotic Exposure and Bronchopulmonary Dysplasia in Very Preterm Infants at Low Risk of Early-Onset Sepsis. https://pubmed.ncbi.nlm.nih.gov/38935376/