Adverse consequences of neonatal antibiotic exposure.

Published

Journal Article (Review)

PURPOSE OF REVIEW: Antibiotics have not only saved lives and improved outcomes, but they also influence the evolving microbiome. This review summarizes reports on neonatal infections and variation in antibiotic utilization, discusses the emergence of resistant organisms, and presents data from human neonates and animal models demonstrating the impact of antibiotics on the microbiome, and how microbiome alterations impact health. The importance of antibiotic stewardship is also discussed. RECENT FINDINGS: Infections increase neonatal morbidity and mortality. Furthermore, the clinical presentation of infections can be subtle, prompting clinicians to empirically start antibiotics when infection is a possibility. Antibiotic-resistant infections are a growing problem. Cohort studies have identified extensive center variations in antibiotic usage and associations between antibiotic exposures and outcomes. Studies of antibiotic-induced microbiome alterations and downstream effects on the developing immune system have increased our understanding of the mechanisms underlying the associations between antibiotics and adverse outcomes. The emergence of resistant microorganisms and recent evidence linking antibiotic practice variations with health outcomes has led to the initiation of antibiotic stewardship programs. SUMMARY: The review encourages practitioners to assess local antibiotic use with regard to local microbiology, and to adopt steps to reduce infections and use antibiotics wisely.

Full Text

Duke Authors

Cited Authors

  • Cotten, CM

Published Date

  • April 2016

Published In

Volume / Issue

  • 28 / 2

Start / End Page

  • 141 - 149

PubMed ID

  • 26886785

Pubmed Central ID

  • 26886785

Electronic International Standard Serial Number (EISSN)

  • 1531-698X

Digital Object Identifier (DOI)

  • 10.1097/MOP.0000000000000338

Language

  • eng

Conference Location

  • United States