Prolonged Early Antibiotic Use and Bronchopulmonary Dysplasia in Very Low Birth Weight Infants

Novitsky, Alexandra; Tuttle, Deborah; Locke, Robert; Saiman, Lisa; Mackley, Amy; Paul, David A.

doi:10.1055/s-0034-1373844

Cited by 59 publications

(43 citation statements)

References 10 publications

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“…Approximately half of these infants received a $7-day course of antibiotics with no antepartum historical risk factors or neonatal clinical signs to explain such a prolonged administration. 19 Novitsky et al 20 reported that only 18% (159 of 960) of VLBW infants received .48 hours of antibiotics during the first week of life, which was substantially lower than what we reported in this study.…”

Section: Discussioncontrasting

confidence: 85%

“…Antibiotic duration .48 hours in the first week after birth was associated with subsequent CLD (31% vs 14%; P , .01) and the presence of resistant bacteria in routine endotracheal aspirate cultures (7% vs 2%; P , .01) in 906 VLBW infants. 20 Cantey et al 21 reported that each additional day of antibiotic therapy in the first 2 weeks after birth was associated with both increased risk and severity of bronchopulmonary dysplasia in 1324 VLBW infants. Prolonged initial empirical antibiotic treatment $5 days with sterile blood cultures was associated with increased odds of NEC and/or death in ELBW infants (n = 5963).…”

Section: Discussionmentioning

confidence: 99%

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Duration of Initial Empirical Antibiotic Therapy and Outcomes in Very Low Birth Weight Infants

et al. 2019

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Section: Discussioncontrasting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Duration of Initial Empirical Antibiotic Therapy and Outcomes in Very Low Birth Weight Infants

et al. 2019

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“…Among them, chorioamnionitis, transplacental infection, or abnormal colonization appear to be able to create an inflammatory process, first step in the pathogenesis of BPD (83). Exposure to prenatal and postnatal antibiotics, respiratory support devices, sepsis, feeding and nutrition, concurrent development of the intestinal microbiome, and the surrounding environmental microbiome, can also be also implicated (82,84,85).…”

Section: The Preterm Lung Microbiota and Bpdmentioning

confidence: 99%

Gut and Lung Microbiota in Preterm Infants: Immunological Modulation and Implication in Neonatal Outcomes

et al. 2019

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In recent years, an aberrant gastrointestinal colonization has been found to be associated with an higher risk for postnatal sepsis, necrotizing enterocolitis (NEC) and growth impairment in preterm infants. As a consequence, the reasons of intestinal dysbiosis in this population of newborns have increasingly become an object of interest. The presence of a link between the gut and lung microbiome's development (gut-lung axis) is emerging, and more data show as a gut-brain cross talking mediated by an inflammatory milieu, may affect the immunity system and influence neonatal outcomes. A revision of the studies which examined gut and lung microbiota in preterm infants and a qualitative analysis of data about characteristic patterns and related outcomes in terms of risk of growing impairment, Necrotizing Enterocolitis (NEC), Bronchopulmonary Dysplasia (BPD), and sepsis have been performed. Microbiota take part in the establishment of the gut barrier and many data suggest its immune-modulator role. Furthermore, the development of the gut and lung microbiome (gut-lung axis) appear to be connected and able to lead to abnormal inflammatory responses which have a key role in the pathogenesis of BPD. Dysbiosis and the gut predominance of facultative anaerobes appear to be crucial to the pathogenesis and subsequently to the prevention of such diseases.

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“…Recently, a strong correlation was found between decreased diversity of the lung microbiome at the time of birth in preterm infants and the development of BPD (149, 152). Other studies correlated prolonged antibiotics use during the first week of life and BPD (153, 154). The protective effect of bacterial exposure in early life on asthma and allergy development, the “hygiene hypothesis,” is extensively studied, and a greater microbial diversity of commensal bacteria seems to underlie this protective effect (148).…”

Section: Current Understanding Of Bpd Pathophysiology New Pathophysimentioning

confidence: 96%

The Future of Bronchopulmonary Dysplasia: Emerging Pathophysiological Concepts and Potential New Avenues of Treatment

Collins¹,

Tibboel²,

Kleer³

et al. 2017

Front. Med.

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Yearly more than 15 million babies are born premature (<37 weeks gestational age), accounting for more than 1 in 10 births worldwide. Lung injury caused by maternal chorioamnionitis or preeclampsia, postnatal ventilation, hyperoxia, or inflammation can lead to the development of bronchopulmonary dysplasia (BPD), one of the most common adverse outcomes in these preterm neonates. BPD patients have an arrest in alveolar and microvascular development and more frequently develop asthma and early-onset emphysema as they age. Understanding how the alveoli develop, and repair, and regenerate after injury is critical for the development of therapies, as unfortunately there is still no cure for BPD. In this review, we aim to provide an overview of emerging new concepts in the understanding of perinatal lung development and injury from a molecular and cellular point of view and how this is paving the way for new therapeutic options to prevent or treat BPD, as well as a reflection on current treatment procedures.

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Prolonged Early Antibiotic Use and Bronchopulmonary Dysplasia in Very Low Birth Weight Infants

Abstract: 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.

Cited by 59 publications

References 10 publications

Duration of Initial Empirical Antibiotic Therapy and Outcomes in Very Low Birth Weight Infants

Duration of Initial Empirical Antibiotic Therapy and Outcomes in Very Low Birth Weight Infants

Gut and Lung Microbiota in Preterm Infants: Immunological Modulation and Implication in Neonatal Outcomes

The Future of Bronchopulmonary Dysplasia: Emerging Pathophysiological Concepts and Potential New Avenues of Treatment

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