title: Prolonged exposure to antibiotics and its associations in extremely preterm neonates--the Western Australian experience.
abstract: BACKGROUND
  Prolonged exposure to antibiotics (PEA) is associated with increased risk of necrotising enterocolitis (NEC), late onset sepsis (LOS) and death in preterm neonates.
  
  
  OBJECTIVE
  To evaluate PEA (≥4 d) for suspected (blood culture negative) sepsis and its association with NEC, LOS and death in extremely preterm (EP: Gestation <28 weeks) neonates.
  
  
  METHODS
  Data on demographic characteristics, antibiotic exposure for early onset sepsis (EOS) or LOS and outcomes to discharge/death were collected for 216 EP neonates admitted between 1/1/2009 and 31/12/2010.
  
  
  RESULTS
  All 216 neonates received antibiotics for suspected EOS; 120/216 (56%) had PEA. 137/216 who survived first 72 h of life, had suspected LOS [range 1-8 episodes], treated with antibiotics for median (IQR) duration of 8 (5-14) days. 89/216 had proven (blood culture positive) LOS [range 1-3 episodes], treated with antibiotics for median (IQR) duration of 10 (7-18) days. The incidence of and death due to ≥Stage II NEC was 17/216 (7.8%) and 5/17 (29.4%) respectively. PEA for suspected EOS was associated with proven LOS (OR: 2.1, 95% CI: 1.2-3.7, p = 0.013) after adjusting for gestation and IUGR, but not with NEC/death.
  
  
  CONCLUSIONS
  PEA for ≥4 d for suspected EOS was associated with increased odds for proven LOS.
authors.affiliation: Department of Neonatal Paediatrics .
authors.forename: P
authors.initials: P
authors.lastname: Shah
authors.forename: E
authors.initials: E
authors.lastname: Nathan
authors.forename: D
authors.initials: D
authors.lastname: Doherty
authors.forename: S
authors.initials: S
authors.lastname: Patole
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001724:Birth Weight; D005260:Female; D005865:Gestational Age; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D012189:Retrospective Studies; D013997:Time Factors; D014904:Western Australia / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents