Study finds infants with low-risk deliveries should not need antibiotics at birth


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Infants born with uncomplicated Cesaria delivery need antibiotics at birth, according to a study by researchers at the Philadelphia Children’s Hospital (CHOP), with no prenatal or membrane rupture, no fear of infection, and no complications. Should not.Survey results announced today Pediatrics, May help clinicians coordinate the use of early antibiotics in newborns. Only those who are considered at risk of infection should be given antibiotics, which can reduce unnecessary use.

“Given the risks associated with early-onset sepsis in infants, it is not surprising that newborns are often given. Antibiotics Immediately after birthLead author Dustin D. Flannery, DO, MSCE, a neonatologist and clinical researcher at the Philadelphia Children’s Hospital, said:Danger delivery Characteristic. Such babies are less likely to be infected at birth and can avoid the potential complications of systemic antibiotic exposure. “

Newborns are at risk of life-threatening early-onset sepsis (EOS) infection It can occur within 72 hours after delivery due to exposure to bacteria during the birth process. However, it is difficult to predict which infant will develop EOS. This results in orders of magnitude higher antibiotic usage compared to the proportion of infants with confirmed infections. Long-term use of antibiotics in newborns is associated with serious adverse outcomes in preterm infants and potential long-term complications in full-term infants, emphasizing the need for better methods for assessing the risk of infection. ..

Since the primary method of exposing newborns to bacteria is the childbirth process, researchers decided to analyze the characteristics of childbirth to see if the provider could help identify the infant with the lowest risk of EOS. did. A retrospective study evaluated all babies born between 2009 and 2014 at two birth hospitals in Philadelphia and who had a blood or cerebrospinal fluid culture within 72 hours of birth.They examine medical record data for confirmed infections and delivery characteristics and provide “low risk” delivery. Caesarean section, Without rupture of the amniotic membrane before delivery; lack of labor or attempt to induce labor; suspected or confirmed maternal intraamniotic infection or lack of fetal dysfunction.

Researchers also included babies born across the spectrum of gestational age. Previous studies evaluated EOS risk in both extremely preterm infants (<28 weeks gestation) and full-term infants (37 weeks and above), but risks in late and moderate preterm infants (28-36 weeks gestation). Few have analyzed. Despite the fact that these infants make up the majority of hospitalizations in the neonatal intensive care unit (NICU).

Overall, 7,549 babies elicited culture and were included in the study. Of these, 1,121 (14.8%) were born in a low-risk delivery environment, and 6,428 (85.2%) did not. A total of 41 infants confirmed cases of EOS. No infected patient was born in a low-risk delivery setting.

Infants born in a low-risk delivery environment did not develop EOS, but 80% of them were empirically treated with antibiotics. There was no difference in the proportion of infants receiving long-term antibiotics between the low-risk and non-low-risk groups, and clinicians did not assess or explain the low risk of infection, and antibiotics if no infection was confirmed. It suggests that the substance has been discontinued.

“In the United States, an estimated 400,000 uninfected term infants receive empirical antibiotics at birth each year, more than 90% of which are extremely. Preterm infant Administer antibiotics, “Dr. Flannery said. Infants No antibiotics needed. Clinicians can use delivery properties as a guide to prevent unnecessary use of antibiotics and avoid potential complications of treatment. ”

Most premature babies are given early antibiotics

For more information:
Dustin D. Flannery et al, Birth Characteristics and Risk of Early Onset Neonatal Sepsis, Pediatrics (2022). DOI: 10.1542 / peds.2021-052900

Quote: According to a study, low-risk delivery infants were obtained from https: // on January 13, 2022 at birth (2022). You shouldn’t need antibiotics on January 13, 2014 birth.html

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