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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.

Journal of Pediatric Gastroenterology and Nutrition
|June 24, 2017
PubMed

Insights

Early antibiotic use in preterm infants significantly increases the risk of feeding intolerance and necrotizing enterocolitis (NEC). This exposure also prolongs the need for total parenteral nutrition, impacting infant health outcomes.

Area of Science:

  • Neonatalogy
  • Pediatric Gastroenterology
  • Clinical Pharmacology

Background:

  • Neonatal feeding intolerance is a significant concern in preterm infants.
  • Clinical practices, including early empiric antibiotic use, are suspected contributors.
  • The precise impact of early antibiotics on feeding tolerance remains unclear.

Purpose of the Study:

  • To investigate the association between early empiric antibiotic exposure and enteral feeding tolerance in preterm infants.
  • To determine the effects of early antibiotics on total parenteral nutrition (TPN) duration and necrotizing enterocolitis (NEC) prevalence.

Main Methods:

  • Retrospective analysis of data from preterm infants (500-1499g, 24-34 weeks gestational age) without sepsis risk factors.
  • Comparison of outcomes between infants exposed to early empiric antibiotics and a control group.
  • Primary outcomes: TPN duration and NEC incidence.

Main Results:

  • Early empiric antibiotic exposure was observed in 67 out of 901 infants.
  • Exposed neonates showed a 50% increase in TPN duration compared to controls.
  • A four-fold higher prevalence of NEC was documented in the early antibiotic-exposed group (P < 0.01).

Conclusions:

  • Early empiric antibiotic exposure negatively impacts enteral feeding tolerance in preterm infants.
  • Antibiotic use is associated with increased TPN duration and a significantly higher risk of NEC.
  • Findings suggest a potential causal link between early antibiotics and adverse gastrointestinal outcomes in neonates.

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