Doctors are giving the majority premature babies antibiotics for too long without being sure the newborns have infections treatable by the drugs, a new study suggests.
Premature babies are vulnerable to sepsis, which may be life-threatening to them and can be prevented with antibiotic treatment.
But early and long-term use of the drugs in the days just following a premature baby’s birth has been linked to the development of antibiotic resistance, other infections and even an increased risk of death.
A new study from the Children’s Hospital of Philadelphia found that more than three-quarters of premature babies are given antibiotics.
About 80 percent of premature babies are given antibiotics within the first few days of life, whether or not they have bacterial infections. This poses risks like developing drug resistance
One in 10 babies in the world is born early with a birth weight below the normal range.
Being born too small raises risks of respiratory and heart problems, disabilities later in life and early death.
These newborns enter the world with an under-developed immune system, so they are more vulnerable to infections and poorly equipped to fight them off.
Both their weaker immune systems and common occurrences in premature births, such as the mother’s inflammation make bacterial infections more likely.
Even normal bacteria from a baby’s own skin can turn deadly if the insertion of a catheter or tube allows the germs to migrate into the newborn’s body cavity.
Any one or a combination of these likely factors can send the immune system into overdrive as it mounts its best defense.
But the rapid release of white blood cells also causes inflammation that can affect every tissue of the body.
This state of septic shock can quickly trigger organ failure, especially in fragile babies with low birth weights.
Since sepsis develops as a complication of common bacterial infections, doctors may want to move quickly to give premature newborns antibiotics, either preventatively or in rapid response to sickness.
If the baby does in fact have a bacterial infection, this practice can make the difference between life and death.
But many infections are viral, and some babies are lucky and dodge infection altogether, making antibiotic treatment useless to them.
What’s more, the unnecessary use of antibiotics in their first days of their lives puts these babies at risk for antibiotic resistance, which could turn a common infection deadly to them later in life, as well as contribute to a global public health concern.
Nonetheless, the new research revealed that 78.6 percent of babies born at very low birth weights – under 2lbs 5oz – and 87 percent of extremely low birth weight (under 2lbs 3ozs) babies receive antibiotics in the first few days after birth.
The authors analyzed data from several sources, bringing the total number of infants included to more than 53,000.
Though the new work does not include data on bacterial cultures performed on these babies, previous work has shown that as many as 56 percent of babies treated with antibiotics for five days or more were negative for a bacterial infection.
‘There is discordance between rates of early antibiotic exposure and incidence of [early-onset sepsis] in premature infants,’ the study authors wrote.
‘These findings suggest a continued need for neonatal antibiotic stewardship efforts designed to help clinicians identify premature infants at lowest risk of [early-onset sepsis] to avoid nonindicated, and perhaps harmful, antibiotic exposure.’