Early Empiric Antibiotic Treatment Among Neonates With Congenital Heart Defects: A Brief Report of an Integrative Review

Abstract

OBJECTIVES: Despite improved rates of survival, neonates with congenital heart defects experience serious comorbidities. Antibiotics are used widely in other critically ill neonates, and exposure in the first 7 days after birth (early empiric antibiotic treatment) has been associated with increased risk of adverse outcomes. The purpose of this brief report is to summarize and evaluate existing evidence pertaining to early empiric antibiotic treatment and associations with adverse outcomes among neonates with congenital heart defects.DESIGN: An integrative review of the literature was performed. SETTING:The search was conducted in PubMed and Ovid Medline, and Global Health databases. Medical Subject Headings terms and Boolean phrases were used. SUBJECTS:Original research articles were included if the study cohort neonates with congenital heart defects, were published in English, and included a description or evaluation of early empiric antibiotic treatment in the first 28 days of life. Endocarditis and postoperative antibiotic prophylaxis investigations were excluded. MAIN RESULTS:Our search generated 249 articles. Search results were listed in an Excel spreadsheet and screened by four authors. Articles that did not pertain to the population of interest were excluded. Fourteen articles were included in the full-text review. Data from these articles were summarized in a table and evaluated by all authors. No articles were found discussing early empiric antibiotic treatment in neonates with congenital heart defects. LIMITATIONS:Our search generated no results, impairing our ability to fulfill the purpose of the brief report. CONCLUSIONS:There have been no studies regarding early empiric antibiotic treatment among neonates with congenital heart defects. Research is needed to understand the prevalence, indications, and potential consequences of early empiric antibiotic treatment in this population.