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Evaluating an Association between Ampicillin and Intraventricular Hemorrhage in Preterm Infants
Eric S Peeples1, Thomas P Strandjord1, Sandra E Juul1
1Department of Pediatrics, University of Washington, Seattle, Washington, United States.
Insights
Early ampicillin administration in preterm infants is linked to a higher risk of intraventricular hemorrhage (IVH). Longer ampicillin courses did not show a significant association with IVH development.
Area of Science:
- Neonatal Medicine
- Pharmacology
- Pediatric Neurology
Background:
- Intraventricular hemorrhage (IVH) is a significant complication in preterm infants, affecting up to 30%.
- Beta-lactam antibiotics, like ampicillin, can influence platelet function, a factor relevant to bleeding events such as IVH.
Purpose of the Study:
- To investigate the association between ampicillin use and the incidence of intraventricular hemorrhage in preterm infants.
- To determine if the timing and duration of ampicillin administration correlate with IVH development.
Main Methods:
- A retrospective case-control study involving preterm, low-birth-weight infants with and without IVH.
- Conditional logistic regression analysis of 10 clinical features from the first week of life.
- Data collected from 174 subjects, with matched controls for demographic factors and illness severity.
Main Results:
- Earlier initiation of ampicillin was significantly associated with increased odds of developing IVH (OR: 0.95, p=0.028).
- No significant association was found between longer durations of ampicillin therapy and the development of IVH (OR: 1.13, p=0.089).
Conclusions:
- The timing of ampicillin administration, specifically earlier use, appears to be a risk factor for IVH in preterm infants.
- Further research is warranted to explore the impact of ampicillin's dose, timing, and duration on IVH outcomes.
Abstract:
Intraventricular hemorrhage (IVH) is a common and potentially devastating adverse outcome affecting up to 30% of preterm infants. β-Lactam antibiotics affect platelet activation through interaction with platelet surface receptors. The objective of this study was to evaluate an association between ampicillin use and the development of IVH in preterm infants. This was a single-center and a retrospective case-control study of preterm low-birth-weight infants diagnosed with IVH and matched controls without IVH. Conditional logistic regression was performed on 10 clinical features from the first week of life to evaluate the association with IVH. Data were obtained for 174 subjects with no significant differences between groups in demographic factors and level of illness indicators. Earlier administration of the first dose of ampicillin was associated with increased odds of developing IVH (odds ratio [OR]: 0.95, p = 0.028) when controlling for other common associations. Longer courses of ampicillin were not significantly associated with the development of IVH (OR: 1.13, p = 0.089). The odds of developing IVH in our population increased with earlier, but not longer initial courses of ampicillin. Further research into the associations with IVH should include the assessment of ampicillin dose, timing, and duration.
