Early Empiric Antibiotic Use Is Associated With Delayed Feeding Tolerance in Preterm Infants: A Retrospective Analysis

The causative factors of neonatal feeding intolerance are poorly understood, but potentially related to clinical practices such as empiric antibiotic usage. The objective of this study was to evaluate whether early empiric antibiotic exposure negatively affects preterm infants' enteral feeding tolerance. Data from infants without risk factors for sepsis, 500 to 1499 g birth weight and 24 to 34 weeks gestational age were analyzed. The primary outcomes were the empiric antibiotic exposure effects on the infants' total parenteral nutrition usage duration and prevalence of necrotizing enterocolitis (NEC). Among the 901 infants included, 67 were exposed to early empiric antibiotic. A 50% increase in parenteral nutrition usage duration and a 4-fold greater prevalence of NEC was seen in the early empiric antibiotic-exposed neonates, when compared with control infants (P<0.01). Early empiric antibiotic exposure appears to negatively influence preterm infant feeding tolerance and possibly contributes to NEC.Brazilian Ministry of HealthUniv Sao Paulo, Fac Med Ribeirao Preto, Sao Paulo, BrazilUniv Sao Paulo, Fac Med Sau Paulo, Sao Paulo, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Sao Paulo, BrazilInst Med Integral Prof Fernando Figueira IMIP, Recife, PE, BrazilUniv Fed Maranhao, Hosp Univ, Sao Luis, BrazilUniv Estadual Campinas, Fac Ciencias Med, Sao Paulo, BrazilUNESP, Fac Med Botucatu, Botucatu, SP, BrazilFiocruz MS, Inst Fernandes Figueira, Rio De Janeiro, BrazilPUC Porto Alegre, Fac Med, Porto Alegre, RS, BrazilUniv Fed Rio Grande do Sul, Porto Alegre, RS, BrazilUniv Estado Rio De Janeiro, Rio De Janeiro, BrazilUniv Fed Minas Gerais, Belo Horizonte, MG, BrazilUniv Fed Uberlandia, Uberlandia, MG, BrazilFac Ciencias Med Minas Gerais, Belo Horizonte, MG, BrazilUniv Sao Paulo, Hosp Univ, Sao Paulo, BrazilHosp Estadual Sumare, Sumare, BrazilHosp Geral Pirajussara, Taboao De Serra, BrazilHosp Estadual Diadema, Diadema, BrazilUniv Estadual Londrina, Londrina, BrazilUniv Fed Parana, Curitiba, Parana, BrazilUniv Toronto, Toronto, ON, CanadaUniv Fed Sao Paulo, Escola Paulista Med, Sao Paulo, BrazilBrazilian Ministry of HealthWeb of Scienc