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Neonatal Antibiotic Treatment Can Affect Stool Pattern and Oral Tolerance in Preterm Infants

Diana Verónica Reyes-García1, Arturo Alejandro Canul-Euan2, María Antonieta Rivera-Rueda1

  • 1Neonatal Intensive Care Unit, National Institute of Perinatology "Isidro Espinosa de los Reyes", Mexico City 11000, Mexico.

Life (Basel, Switzerland)
|July 27, 2022
PubMed

Insights

Antibiotic treatment in preterm infants delays meconium passage and enteral feeding tolerance. Longer antibiotic exposure is linked to poorer gut function and oral feeding outcomes in premature neonates.

Area of Science:

  • Neonatal Medicine
  • Pediatric Gastroenterology
  • Microbiome Research

Background:

  • Preterm neonates face high risks of infection, often requiring antibiotic treatment (ABT).
  • Antibiotic use impacts the neonatal gut microbiome, potentially causing dysbiosis and delayed gastrointestinal transit.
  • Faster meconium passage in neonates correlates with better enteral feeding tolerance.

Purpose of the Study:

  • To investigate the impact of neonatal antibiotic treatment duration on stool patterns and oral feeding tolerance in preterm infants.
  • To identify associations between antibiotic exposure and key gastrointestinal milestones in premature neonates.

Main Methods:

  • Analysis of 106 preterm infants (<33 weeks gestational age) categorized by neonatal antibiotic treatment duration (none, 3–7 days, ≥8 days).
  • Evaluation of stool patterns (meconium passage, stool color progression) and enteral feeding milestones (time to reach specific volumes).
  • Utilized multiple linear regression models to identify associated factors.

Main Results:

  • Infants receiving ≥8 days of antibiotics showed delayed meconium passage and stool color progression compared to those with no or shorter ABT.
  • Prolonged antibiotic exposure was associated with longer times to achieve enteral feeding volumes (100 and 150 mL/kg/day).
  • Reduced enteral feed volumes were observed at days of life 14 and 28 in the prolonged ABT group.
  • Neonatal antibiotic treatment, birth weight, mechanical ventilation, surfactant use, feeding start day, parenteral nutrition, and fasting days were significant factors.

Conclusions:

  • Extended neonatal antibiotic treatment negatively affects stool patterns and oral feeding tolerance in preterm infants.
  • Antibiotic-induced gut dysbiosis may underlie the observed delays in gastrointestinal function and feeding progression.
  • Factors beyond antibiotics, including birth weight and medical interventions, also significantly influence these outcomes.

Keywords:
delayed meconium passageempirical antibioticenteral feeding volumesgreen stoolsmeconiumneonatal antibioticpreterm infant feeding tolerancepreterm infant oral feedingpreterm infant stool patternyellow stools

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