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When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
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Variation in antibiotic consumption in very preterm infants-a 10 year population-based study.

Zuzana Huncikova1,2, Hans Jørgen Stensvold3, Knut Asbjørn Alexander Øymar1,2

  • 1Paediatric Department, Stavanger University Hospital, Stavanger, Norway.

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|November 21, 2023
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Antibiotic use in very preterm infants decreased over ten years in Norway, but significant regional variations persisted. This highlights the need for antibiotic stewardship to combat resistance development.

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Area of Science:

  • Neonatal Medicine
  • Infectious Diseases
  • Pharmacology

Background:

  • Wide variations in antibiotic use among very preterm infants exist despite similar infection rates.
  • Antibiotic resistance is a growing global health concern.

Purpose of the Study:

  • To analyze 10-year trends in antibiotic consumption.
  • To investigate regional variations in antibiotic use among very preterm infants in Norway.
  • To assess the relationship between antibiotic use and sepsis-attributable mortality.

Main Methods:

  • Retrospective analysis of all live-born very preterm infants (<32 weeks gestation) in Norway (2009-2018).
  • Antibiotic consumption measured as days of therapy (DOT) per 1000 patient days (PD).
  • Comparison of antibiotic use, sepsis rates, and mortality across four health regions.

Main Results:

  • 80% of 5296 very preterm infants received antibiotics.
  • Overall antibiotic consumption decreased significantly, driven by reduced use of narrow-spectrum β-lactams and aminoglycosides.
  • Consumption of broad-spectrum β-lactams and vancomycin showed marked regional variations but did not correlate with sepsis-attributable mortality.

Conclusions:

  • Overall antibiotic consumption in very preterm infants declined between 2009 and 2018.
  • Significant regional disparities in the use of certain antibiotics persist.
  • Antibiotic stewardship programs are crucial to reduce unnecessary antibiotic use and mitigate the development of antibiotic resistance.