高危早产儿初始预防性抗生素使用与随后的坏死性小肠结肠炎：一项系统评价和荟萃分析。
The initial prophylactic antibiotic usage and subsequent necrotizing enterocolitis in high-risk premature infants: a systematic review and meta-analysis.
作者信息
Fan Xue, Zhang Li, Tang Jun, Chen Chao, Chen Juan, Qu Yi, Mu Dezhi
机构信息
Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
出版信息
Pediatr Surg Int. 2018 Jan;34(1):35-45. doi: 10.1007/s00383-017-4207-z. Epub 2017 Nov 11.
OBJECTIVE
To investigate the correlation between the initial prophylactic antibiotic use and the subsequent NEC in high-risk premature infants.
METHODS
We performed a literature search of PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), and the Web of Science, and nine studies with a total of 5207 infants were selected for inclusion in this study.
RESULTS
The pooled estimate for the seven studies combined indicating that prophylactic antibiotic usage was associated with a non-significant trend toward increased incidence of NEC [odds ratio (OR) 0.75; 95% confidence interval (CI) 0.26-2.17], and prolonged exposure to prophylactic antibiotics, compared with limited prophylactic antibiotic use, was associated with a significant trend toward the risk of increasing incidence of NEC (OR 1.31; 95% CI 1.08-1.59).
CONCLUSION
Current evidence does not support the use of prophylactic antibiotics to reduce the incidence of NEC for high-risk premature infants.
目的
探讨高危早产儿初始预防性使用抗生素与随后发生坏死性小肠结肠炎（NEC）之间的相关性。
方法
我们对PubMed、EMBASE、Cochrane对照试验中央注册库（CENTRAL）和科学网进行了文献检索，共纳入9项研究，总计5207例婴儿。
结果
7项研究的合并估计表明，预防性使用抗生素与NEC发病率增加的趋势无显著相关性[比值比（OR）0.75；95%置信区间（CI）0.26 - 2.17]，与有限预防性使用抗生素相比，长期使用预防性抗生素与NEC发病率增加风险的显著趋势相关（OR 1.31；95% CI 1.08 - 1.59）。
结论
目前的证据不支持使用预防性抗生素来降低高危早产儿NEC的发病率。
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