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Am J Perinatol 2020; 37(12): 1250-1257
DOI: 10.1055/s-0039-1693429
Original Article

Antibiotic Treatments and Patient Outcomes in Necrotizing Enterocolitis

Catherine Murphy   *
1   Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York
,
Jayasree Nair
2   Division of Neonatology, Department of Pediatrics, University at Buffalo, State University of New York, Buffalo, New York
,
Brian Wrotniak
3   Department of Pediatrics, University at Buffalo, State University of New York, Buffalo, New York
,
Emily Polischuk
4   Department of Pharmacy, John R. Oishei Children's Hospital of Buffalo, Buffalo, New York
,
Shamim Islam
5   Division of Infectious Diseases, Department of Pediatrics, University at Buffalo, State University of New York, Buffalo, New York
› Author Affiliations Funding None.
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Abstract

Objective This study aimed to examine the impact of different antibiotic treatments on necrotizing enterocolitis (NEC) outcomes.

Study Design Patient outcomes, including total parenteral nutrition and hospitalization durations, abdominal surgeries, intestinal strictures, and mortality data, were analyzed and compared by various antibiotic groups and treatment durations for 160 NEC patients managed at the Women and Children's Hospital of Buffalo between 2008 and 2016.

Results Fourteen different antibiotics were used for NEC, most commonly ampicillin, gentamicin, and metronidazole (AGM). Medical (vs. surgical) NEC patients more likely received AGM (37 vs. 6%, p < 0.001). Surgical (vs. medical) NEC patients more likely received vancomycin (80 vs. 30%, p < 0.001) and antipseudomonal agents (69 vs. 15%, p < 0.001). For medical NEC there were no outcome differences between patients receiving only AGM versus those receiving other treatments; in patients receiving AGM, there were no outcome differences in durations of ≤10 days versus longer courses.

Conclusion Antibiotic use for NEC varies substantially without definite outcome differences. Particularly with medical NEC, AGM for ≤10 days had comparable outcomes to other treatments. In light of growing concern for short and longer term adverse effects with early-life antibiotic exposure, narrow-spectrum and shorter course NEC treatment may be preferred.

Keywords

necrotizing enterocolitis - antibiotics - antibiotic management for NEC

* Catherine Murphy’s current affiliation is Pediatrics Residency Program, New York Medical College, Valhalla, New York.


Supplementary Material



Publication History

Received: 18 January 2019

Accepted: 06 June 2019

Article published online:
15 July 2019

© 2020. Thieme. All rights reserved.

Thieme Medical Publishers
333 Seventh Avenue, New York, NY 10001, USA.

 

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