Most Premature Infants Receive Early Antibiotics

Variation across centers in early antibiotic exposures, prolonged antibiotic administration.
Variation across centers in early antibiotic exposures, prolonged antibiotic administration.

HealthDay News — Most premature infants receive empirical antibiotic therapy, according to a study published online May 25 in JAMA Network Open.

Dustin D. Flannery, DO, from the Children's Hospital of Philadelphia, and colleagues examined early antibiotic use among premature infants in a retrospective cohort study using a comprehensive administrative database of inpatient encounters from 297 academic and community US hospitals. 

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The researchers identified 40,364 very low-birth-weight (VLBW) infants who survived at least one day, including 12,947 extremely low-birth-weight (ELBW) infants. Most premature infants had early antibiotic initiation (78.6 and 87 percent of VLBW and ELBW infants, respectively); in temporal trend analyses, there were no differences over time for VLBW or ELBW infants. Over time, a small but significant decrease was seen in the rate of prolonged antibiotic duration for VLBW infants but not for ELBW infants. Across centers, there was variation in early antibiotic exposures; 61.1 and 84.8% of centers started antibiotic therapy for more than 75% of VLBW and ELBW infants, respectively. There was also variation across centers in the proportion of VLBW and ELBW infants administered prolonged antibiotics, from 0 to 80.4% and from 0 to 92%, respectively.

"The variability in exposure rates across centers, however, suggests that neonatal antimicrobial stewardship efforts are warranted to optimize antibiotic use for VLBW and ELBW infants," the authors write.

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