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Early Empiric Antibiotic Use Is Associated With Delayed Feeding Tolerance in Preterm Infants: A Retrospective
Francisco E Martinez1, Walusa A G Ferri, Clea R Leone
1*Faculty of Medicine Ribeirão Preto-Universidade de São Paulo †Faculty of Medicine São Paulo-Universidade de São Paulo, São Paulo ‡Escola Paulista de Medicina, Universidade Federal de São Paulo §Instituto de Medicina Integral Prof Fernando Figueira-IMIP, Recife ||Hospital Universitário da Universidade Federal do Maranhão, São Luís ¶Faculdade de Ciencias Médicas-UNICAMP, São Paulo #Faculdade de Medicina de Botucatu-UNESP, Botucatu **Instituto Fernandes Figueira-FIOCRUZ, Rio de Janeiro ††Faculdade de Medicina da PUC Porto Alegre ‡‡Universidade Federal do Rio Grande do Sul, Porto Alegre §§Universidade Estadual do Rio de Janeiro, Rio de Janeiro ||||Universidade Federal de Minas Gerais, Belo Horizonte ¶¶Universidade Federal de Uberlândia, Uberlândia ##Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte ***Hospital Universitário da Universidade de São Paulo, São Paulo †††Hospital Estadual Sumaré, Sumaré ‡‡‡Hospital Geral de Pirajussara, Taboão da Serra §§§Hospital Estadual de Diadema, Diadema ||||||Universidade Estadual de Londrina, Londrina ¶¶¶Universidade Federal do Paraná, Curitiba, Brazil ###University of Toronto, Toronto, Canada.
Abstract:
The causative factors of neonatal feeding intolerance are poorly understood, but potentially related to clinical practices such as empiric antibiotic usage. The objective of this study was to evaluate whether early empiric antibiotic exposure negatively affects preterm infants' enteral feeding tolerance. Data from infants without risk factors for sepsis, 500 to 1499 g birth weight and 24 to 34 weeks gestational age were analyzed. The primary outcomes were the empiric antibiotic exposure effects on the infants' total parenteral nutrition usage duration and prevalence of necrotizing enterocolitis (NEC). Among the 901 infants included, 67 were exposed to early empiric antibiotic. A 50% increase in parenteral nutrition usage duration and a 4-fold greater prevalence of NEC was seen in the early empiric antibiotic-exposed neonates, when compared with control infants (P < 0.01). Early empiric antibiotic exposure appears to negatively influence preterm infant feeding tolerance and possibly contributes to NEC.
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