Antibiotic Therapy for Very Low Birth Weigh Newborns in NICU.
BACKGROUND
Prolonged empiric antibiotics therapy in neonates results in several adverse consequences including widespread antibiotic resistance, late onset sepsis (LOS), necrotizing enterocolitis (NEC), prolonged hospital course (HC) and increase in mortality rates.


OBJECTIVE
To assess the risk factors and the outcome of prolonged empiric antibiotic therapy in very low birth weight (VLBW) newborns.


METHODS
Prospective study in VLBW neonates admitted to NICU and survived > 2 W, from July 2011 - June 2012. All relevant perinatal and postnatal data including duration of antibiotics therapy (Group I < 2W vs Group II > 2W) and outcome up to the time of discharge or death were documented and compared.


RESULTS
Out of 145 newborns included in the study, 62 were in group I, and 83 in Group II. Average duration of antibiotic therapy was 14 days (range 3 - 62 days); duration in Group I and Group II was 10 ± 2.3 vs 25.5 ± 10.5 days. Hospital stay was 22.3 ± 11.5 vs 44.3 ± 14.7 days, respectively. Multiple regression analysis revealed following risk factors as significant for prolonged empiric antibiotic therapy: VLBW especially < 1000 g, (P < 0.001), maternal Illness (P = 0.003), chorioamnionitis (P = 0.048), multiple pregnancy (P = 0.03), non-invasive ventilation (P < 0.001) and mechanical ventilation (P < 0.001). Seventy (48.3%) infants developed LOS; 5 with NEC > stage II, 12 (8.3%) newborns died. Infant mortality alone and with LOS/NEC was higher in group II as compared to group I (P < 0.002 and < 0.001 respectively).


CONCLUSIONS
Prolonged empiric antibiotic therapy caused increasing rates of LOS, NEC, HC and infant mortality.
Shahid Beheshti University of Medical Sciences (SBUMS), Tehran, IR Iran.
Seyyed-Abolfazl
SA
Afjeh
Shahid Beheshti University of Medical Sciences (SBUMS), Tehran, IR Iran.
Mohammad-Kazem
MK
Sabzehei
Shahid Beheshti University of Medical Sciences (SBUMS), Tehran, IR Iran.
Seyyed-Ali-Reza
SA
Fahimzad
Shahid Beheshti University of Medical Sciences (SBUMS), Tehran, IR Iran.
Farideh
F
Shiva
Shahid Beheshti University of Medical Sciences (SBUMS), Tehran, IR Iran.
Ahmad-Reza
AR
Shamshiri
Shahid Beheshti University of Medical Sciences (SBUMS), Tehran, IR Iran.
Fatemeh
F
Esmaili
Antibiotics; Newborns; VLBW