Adverse consequences of neonatal antibiotic exposure
| Autor: | C M Cotten |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Drug Utilization
medicine.medical_specialty medicine.drug_class Antibiotics Drug resistance Article 03 medical and health sciences 0302 clinical medicine Intensive Care Units Neonatal 030225 pediatrics Drug Resistance Bacterial medicine Animals Humans 030212 general & internal medicine Microbiome Practice Patterns Physicians' Intensive care medicine Extramural Practice patterns business.industry Microbiota Infant Newborn Recem nascido Antibiotic exposure Bacterial Infections Anti-Bacterial Agents Pediatrics Perinatology and Child Health business |
| Zdroj: | Current Opinion in Pediatrics. 28:141-149 |
| ISSN: | 1040-8703 |
| DOI: | 10.1097/mop.0000000000000338 |
| Popis: | 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.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.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. |
| Databáze: | OpenAIRE |
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