Antibiotic exposure does not elevate risk of BPD, death in preterm infants
Among preterm infants without culture-confirmed sepsis, exposure to antibiotics in the first week of life is not independently associated with an elevated risk of bronchopulmonary dysplasia (BPD) or death, according to a study.
A total of 4,950 infants were included, of whom 3,946 received antibiotics during the first week of life. Those treated with antibiotics had significantly higher rates of BPD of death (41.5 percent vs 31.1 percent; p<0.001) and the two individual outcomes.
However, after adjusting for potential confounding variables, no association was observed between antibiotic use in the first week of life and increased risk of BPD or death (odds ratio [OR], 0.96; 95 percent CI, 0.76–1.21), or BPD among survivors (OR, 0.86; 0.67–1.09).
Furthermore, antibiotic use correlated with increased risk of death prior to 36 weeks postmenstrual age (PMA; OR, 3.01; 1.59–5.71), but secondary analyses showed that unmeasured illness severity may confound this association.
An earlier study involving very low birth weight infants found that each additional day of antibiotic therapy during the first 2 weeks of life correlated with both an increased risk and severity of BPD. [J Pediatr 2017;181:289-293.e1]
Data from the Optum Neonatal Database were obtained for this retrospective cohort study. Participants included infants without culture-confirmed sepsis born <1,500 g and <32 weeks gestation between January 2010 and November 2016.
The authors used multivariable logistic regression to assess the independent association between antibiotic therapy during the first week of life and BPD or death prior to 36 weeks PMA.