title: Prolonged early antibiotic use and bronchopulmonary dysplasia in very low birth weight infants.
abstract: OBJECTIVE
  The objective of the article is to determine if > 48 hours of antibiotic treatment during the 1st week of life is associated with subsequent isolation of bacteria from the endotracheal tube (ETT), and an increased risk of bronchopulmonary dysplasia (BPD).
  
  
  METHODS
  Retrospective cohort study of very low birth weight infants. Routine weekly surveillance ETT cultures were obtained to monitor bacterial colonization in all intubated infants. Risk factors for BPD were assessed using unadjusted and multivariable analyses.
  
  
  RESULTS
  In the study sample (n = 906), infants with BPD (n = 182) were more likely to have received > 48 hours antibiotic treatment (31 vs. 14%, p < 0.01) and have a resistant gram-negative bacilli in ETT (7 vs. 2%, p = 0.0001) compared with infants without BPD. Treatment with > 48 hours of antibiotics remained associated with BPD (adjusted odds ratio, 2.2; 95% confidence interval, 1.4-3.5) after controlling for confounding variables.
  
  
  CONCLUSIONS
  Antibiotic duration > 48 hours in the 1st week of life was associated with subsequent BPD and the presence of resistant bacteria in routine ETT cultures.
authors.affiliation: Department of Neonatology, Chester County Hospital, West Chester, Pennsylvania.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Novitsky
authors.affiliation: Section of Neonatology, Department of Pediatrics, Christiana Care Health System, Newark, Delaware.
authors.forename: Deborah
authors.initials: D
authors.lastname: Tuttle
authors.affiliation: Section of Neonatology, Department of Pediatrics, Christiana Care Health System, Newark, Delaware.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Locke
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics, Morgan Stanley Children's Hospital, Columbia University, New York.
authors.forename: Lisa
authors.initials: L
authors.lastname: Saiman
authors.affiliation: Section of Neonatology, Department of Pediatrics, Christiana Care Health System, Newark, Delaware.
authors.forename: Amy
authors.initials: A
authors.lastname: Mackley
authors.affiliation: Section of Neonatology, Department of Pediatrics, Christiana Care Health System, Newark, Delaware.
authors.forename: David A
authors.initials: DA
authors.lastname: Paul
mesh_terms: D000667:Ampicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001419:Bacteria / Q000302:isolation & purification*; D001997:Bronchopulmonary Dysplasia / Q000453:epidemiology*; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007442:Intubation, Intratracheal / Q000295:instrumentation; D008297:Male; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000188:drug therapy*; D013997:Time Factors; D014640:Vancomycin / Q000008:administration & dosage
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D014640:Vancomycin; D000667:Ampicillin