Original ArticleAntibiotic Exposure in the Newborn Intensive Care Unit and the Risk of Necrotizing Enterocolitis
Section snippets
Methods
A retrospective, 2:1 control/case analysis was performed to investigate the association between the duration of antimicrobial therapy and subsequent diagnosis of NEC among neonates born from January 1, 2000 to December 31, 2008, and admitted to the Newborn Special Care Unit (NBSCU) at Yale-New Haven Children’s Hospital. The NBSCU is a 54-bed, level IIIc16 NICU for infants with complex medical and surgical conditions.
Cases included neonates diagnosed with NEC modified Bell’s stage ≥IIA.17 Each
Results
The 124 cases of NEC were matched with 248 control subjects. Neonates with NEC were diagnosed, on average, at day of life 22 ± 15, with 51% receiving only medical treatment and 49% undergoing surgical intervention. Cases and control subjects were well matched with respect to gestational age (28.2 ± 3.4 weeks in cases vs 28.1 ± 3.4 weeks in control subjects; P = .849), birth weight (1162 ± 573 g in cases vs 1169 ± 584 g in control subjects; P = .902), and year of admission to the NBSCU (P =
Discussion
The findings support our hypothesis that increased duration of antibiotic exposure in NICU patients may increase their risk of NEC although, because of the confounding relationship between sepsis and antibiotic use, this was only found in neonates without a prior documented bloodstream infection. Antibiotic use in the neonatal population has been previously described as a potential contributing factor in the development of NEC. Antibiotic administration may result in suppression or eradication
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Supported by the National Center for Research Resources (NCRR) (CTSA grant UL1 RR024139), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH. The authors declare no conflicts of interest.