In The News: Antibiotic Overuse in Preemies’ Early Life Tied to Higher Risk of BPD, Death

A national cohort study from China, according to Medpage Today, found antibiotic overuse in premature infants’ early life may increase the risk of bronchopulmonary dysplasia or death. The study included 6,510 premature newborns considered low-risk for early-onset sepsis. Compared to no exposure, researchers found prolonged exposure in the first week of life was associated with 23% higher odds of moderate to severe BPD or death.

Analyses from the research covered in the article found survivors at 36 weeks’ gestational age had higher BPD risk with prolonged antibiotic exposure and with any use of broad-spectrum antibiotics. The article points out the American Academy of Pediatrics recommends discontinuation of antibiotics by 36 to 48 hours for infants at low risk for early-onset sepsis if blood cultures are sterile. However, a 2017 study showed more than a third of U.S. newborns received prolonged antibiotics courses despite their low-risk consideration.

The study is said to be the latest linking prolonged antibiotic use in premature infants and increases in severe outcomes. Its focus on respiratory infections and pulmonary disease, as a result of preterm birth, is not as clear cut in the research. Researchers noted among the limitations of the study were the observational design, the exclusion of infants with severe illnesses, and the nature of BPD development. Still, one doctor commented the study reaffirms the “cultural shift” needed to reduce antibiotic overuse many have actively engaged in fostering.

Researchers used the Chinese Neonatal Network to identify very preterm infants at low risk of early-onset sepsis. To be categorized as low risk, infants needed to be born via c-section, have no membrane rupture at delivery, and lack clinical features of chorioamnionitis. Those with early sepsis or major congenital anomalies were excluded, among other criteria.