Early Antibiotic Exposure in Low-Risk Late Preterm and Term InfantsFunding None.
Objective This study aimed to examine the epidemiology of antibiotic exposure and early onset sepsis (EOS) in late preterm and term infants born via cesarean section with rupture of membranes less than 10 minutes.
Study design Retrospective review of 1,187 late preterm and term infants born at Brooke Army Medical Center between January 1, 2012 and August 29, 2019. Subjects were assessed for factors related to antibiotic treatment. Statistical analysis was performed to compare infants treated with antibiotics versus observation.
Result An early blood culture was obtained from 234 (19.7%) infants; 170 (14.3%) were treated with antibiotics. Infants treated with antibiotics were significantly younger (p < 0.0001), smaller (p < 0.0001), more often diagnosed with respiratory distress (p < 0.0001), and were more frequently admitted to the neonatal intensive care unit (p < 0.0001). There were no cases of culture proven EOS.
Conclusion Although this population lacks risk factors for the development of EOS, a significant percentage was treated with antibiotics. This population may benefit from future antibiotic stewardship efforts.
This population is at risk for respiratory morbidity.
There were no cases of culture proven early onset sepsis.
This is a group of interest for antibiotic stewardship.
Eingereicht: 22. Juni 2021
Angenommen: 16. Juli 2021
07. September 2021 (online)
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- 1 Puopolo KM, Draper D, Wi S. et al. Estimating the probability of neonatal early-onset infection on the basis of maternal risk factors. Pediatrics 2011; 128 (05) e1155-e1163
- 2 Vidic Z, Blickstein I, Štucin Gantar I, Verdenik I, Tul N. Timing of elective cesarean section and neonatal morbidity: a population-based study. J Matern Fetal Neonatal Med 2016; 29 (15) 2461-2463
- 3 Tita AT, Landon MB, Spong CY. et al; Eunice Kennedy Shriver NICHD Maternal-Fetal Medicine Units Network. Timing of elective repeat cesarean delivery at term and neonatal outcomes. N Engl J Med 2009; 360 (02) 111-120
- 4 Morrison JJ, Rennie JM, Milton PJ. Neonatal respiratory morbidity and mode of delivery at term: influence of timing of elective caesarean section. Br J Obstet Gynaecol 1995; 102 (02) 101-106
- 5 Zanardo V, Simbi AK, Franzoi M, Soldà G, Salvadori A, Trevisanuto D. Neonatal respiratory morbidity risk and mode of delivery at term: influence of timing of elective caesarean delivery. Acta Paediatr 2004; 93 (05) 643-647
- 6 Keszler M, Carbone MT, Cox C, Schumacher RE. Severe respiratory failure after elective repeat cesarean delivery: a potentially preventable condition leading to extracorporeal membrane oxygenation. Pediatrics 1992; 89 (4 Pt 1): 670-672
- 7 Nordeng H, Spigset O. Treatment with selective serotonin reuptake inhibitors in the third trimester of pregnancy: effects on the infant. Drug Saf 2005; 28 (07) 565-581
- 8 Puopolo KM, Benitz WE, Zaoutis TE. Committee on Fetus and Newborn, Committee on Infectious Diseases. Management of neonates born at ≥35 0/7 weeks' gestation with suspected or proven early-onset bacterial sepsis. Pediatrics 2018; 142 (06) e20182894
- 9 Cotten CM. Adverse consequences of neonatal antibiotic exposure. Curr Opin Pediatr 2016; 28 (02) 141-149
- 10 Mukhopadhyay S, Sengupta S, Puopolo KM. Challenges and opportunities for antibiotic stewardship among preterm infants. Arch Dis Child Fetal Neonatal Ed 2019; 104 (03) F327-F332
- 11 Cox LM, Yamanishi S, Sohn J. et al. Altering the intestinal microbiota during a critical developmental window has lasting metabolic consequences. Cell 2014; 158 (04) 705-721