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J Pediatr DOI:10.1016/j.jpeds.2014.01.010

Early empiric antibiotic use in preterm infants is associated with lower bacterial diversity and higher relative abundance of Enterobacter.

Publication TypeJournal Article
Year of Publication2014
AuthorsGreenwood, C, Morrow, AL, Lagomarcino, AJ, Altaye, M, Taft, DH, Yu, Z, Newburg, DS, Ward, DV, Schibler, KR
JournalJ Pediatr
Volume165
Issue1
Pages23-9
Date Published2014 Jul
ISSN1097-6833
KeywordsAmpicillin, Anti-Bacterial Agents, Biodiversity, Cohort Studies, DNA Fingerprinting, DNA, Ribosomal, Enterobacter, Female, Gentamicins, Gestational Age, Humans, Infant, Newborn, Infant, Premature, Intestines, Longitudinal Studies, Male, Microbiota, Ohio, RNA, Ribosomal, 16S
Abstract

OBJECTIVES: To determine the impact of empiric ampicillin and gentamicin use in the first week of life on microbial colonization and diversity in preterm infants.

STUDY DESIGN: The 16s ribosomal DNA community profiling was used to compare the microbiota of 74 infants born ≤32 weeks gestational age by degree of antibiotic use in the first week of life. The degree of antibiotic use was classified as 0 days, 1-4 days, and 5-7 days of antibiotic administration. All of the antibiotic use was empiric, defined as treatment based solely on clinical suspicion of infection without a positive culture result.

RESULTS: Infants who received 5-7 days of empiric antimicrobial agents in the first week had increased relative abundance of Enterobacter (P = .016) and lower bacterial diversity in the second and third weeks of life. Infants receiving early antibiotics also experienced more cases of necrotizing enterocolitis, sepsis, or death than those not exposed to antibiotics.

CONCLUSIONS: Early empiric antibiotics have sustained effects on the intestinal microbiota of preterm infants. Intestinal dysbiosis in this population has been found to be associated with elevated risk of necrotizing enterocolitis, sepsis, or death.

URLhttp://linkinghub.elsevier.com/retrieve/pii/S0022-3476(14)00011-0
DOI10.1016/j.jpeds.2014.01.010
Pubmed

http://www.ncbi.nlm.nih.gov/pubmed/24529620?dopt=Abstract

Alternate JournalJ. Pediatr.
PubMed ID24529620
PubMed Central IDPMC4074569
Grant ListU01 RR026314 / RR / NCRR NIH HHS / United States
HHSN272200900018C / AI / NIAID NIH HHS / United States
HD27853 / HD / NICHD NIH HHS / United States
P01 HD013021 / HD / NICHD NIH HHS / United States
UG1 HD027853 / HD / NICHD NIH HHS / United States
HG005969 / HG / NHGRI NIH HHS / United States
HD13021 / HD / NICHD NIH HHS / United States
U10 HD040689 / HD / NICHD NIH HHS / United States
U10 HD027853 / HD / NICHD NIH HHS / United States
HD059140 / HD / NICHD NIH HHS / United States
HHSN272200900018C / / PHS HHS / United States
R01 HG005969 / HG / NHGRI NIH HHS / United States
R01 HD059140 / HD / NICHD NIH HHS / United States
T32 ES010957 / ES / NIEHS NIH HHS / United States
U19 AI110818 / AI / NIAID NIH HHS / United States
UL1 RR026314 / RR / NCRR NIH HHS / United States