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Variability in antibiotic duration for necrotizing enterocolitis and outcomes in a large multicenter cohort
Irfan Ahmad1, Muralidhar H Premkumar2, Amy B Hair2
1CHOC Children's Hospital, Orange, CA, USA. iahmad@choc.org.
Summary
Antibiotic duration for necrotizing enterocolitis (NEC) varies widely in neonatal intensive care units (NICUs). Longer antibiotic use correlates with extended recovery times, including time to full feeds and overall length of stay.
Area of Science:
- Neonatal Medicine
- Pediatric Surgery
- Infectious Disease Management
Background:
- Necrotizing enterocolitis (NEC) is a serious condition in premature infants.
- Antibiotic therapy is a cornerstone of NEC management, but optimal duration is debated.
- Variability in antibiotic prescribing practices may impact patient outcomes.
Purpose of the Study:
- To assess the variability in antibiotic duration for infants with NEC.
- To identify factors associated with antibiotic duration.
- To evaluate the relationship between antibiotic duration and clinical outcomes such as time to full feeds and length of stay.
Main Methods:
- Retrospective analysis of 591 infants with NEC from 22 centers in the Children's Hospitals Neonatal Consortium (CHNC).
- Multivariable analyses were employed to identify predictors of variability in time to full feeds (TFF) and length of stay (LOS).
Main Results:
- Median antibiotic duration was 12 days for medical NEC and 17 days for surgical NEC.
- Significant variability in antibiotic use was observed within and among participating centers.
- Longer antibiotic duration was associated with increased TFF and LOS in both medical and surgical NEC cohorts.
Conclusions:
- Antibiotic prescribing for NEC demonstrates considerable variability across high-level NICUs.
- Current antibiotic durations may be associated with prolonged recovery periods.
- Further research is warranted to establish evidence-based guidelines for optimal antibiotic duration in NEC.
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