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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.

DOI:10.1007/s00383-017-4207-z
PMID:29128874
Abstract

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.

摘要

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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The initial prophylactic antibiotic usage and subsequent necrotizing enterocolitis in high-risk premature infants: a systematic review and meta-analysis.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。
Pediatr Surg Int. 2018 Jan;34(1):35-45. doi: 10.1007/s00383-017-4207-z. Epub 2017 Nov 11.
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本文引用的文献

1
Current research in necrotizing enterocolitis.坏死性小肠结肠炎的当前研究
Early Hum Dev. 2016 Jun;97:33-9. doi: 10.1016/j.earlhumdev.2016.01.013. Epub 2016 Feb 28.
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Necrotizing enterocolitis: controversies and challenges.坏死性小肠结肠炎:争议与挑战
F1000Res. 2015 Nov 30;4. doi: 10.12688/f1000research.6888.1. eCollection 2015.
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Enteral but not parenteral antibiotics enhance gut function and prevent necrotizing enterocolitis in formula-fed newborn preterm pigs.肠内而非肠外抗生素可增强配方奶喂养的新生早产猪的肠道功能并预防坏死性小肠结肠炎。
临床 NEC 预防措施可改变早产儿肠道的微生物组特征和功能反应。
Nat Commun. 2023 Mar 11;14(1):1349. doi: 10.1038/s41467-023-36825-1.
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Prevention of necrotizing enterocolitis in premature infants - an updated review.早产儿坏死性小肠结肠炎的预防——最新综述
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Oral antibiotics increase blood neutrophil maturation and reduce bacteremia and necrotizing enterocolitis in the immediate postnatal period of preterm pigs.口服抗生素可促进早产仔猪出生后即刻的血液中性粒细胞成熟,并减少菌血症和坏死性小肠结肠炎。
Innate Immun. 2016 Jan;22(1):51-62. doi: 10.1177/1753425915615195. Epub 2015 Nov 11.
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Broad-spectrum Antibiotic Plus Metronidazole May Not Prevent the Deterioration of Necrotizing Enterocolitis From Stage II to III in Full-term and Near-term Infants: A Propensity Score-matched Cohort Study.广谱抗生素联合甲硝唑可能无法预防足月儿和近足月儿坏死性小肠结肠炎从Ⅱ期恶化为Ⅲ期:一项倾向评分匹配队列研究。
Medicine (Baltimore). 2015 Oct;94(42):e1862. doi: 10.1097/MD.0000000000001862.
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Intestinal microbiota and its relationship with necrotizing enterocolitis.肠道微生物群及其与坏死性小肠结肠炎的关系。
Pediatr Res. 2015 Sep;78(3):232-8. doi: 10.1038/pr.2015.97. Epub 2015 May 20.
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Neonatal intensive care unit antibiotic use.新生儿重症监护病房抗生素使用。
Pediatrics. 2015 May;135(5):826-33. doi: 10.1542/peds.2014-3409. Epub 2015 Apr 20.
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Pathogenesis of neonatal necrotizing enterocolitis.新生儿坏死性小肠结肠炎的发病机制。
Pediatr Surg Int. 2015 Jun;31(6):509-18. doi: 10.1007/s00383-015-3697-9. Epub 2015 Apr 9.
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Preterm infant nutrition, gut bacteria, and necrotizing enterocolitis.早产婴儿营养、肠道细菌与坏死性小肠结肠炎
Curr Opin Clin Nutr Metab Care. 2015 May;18(3):285-8. doi: 10.1097/MCO.0000000000000169.
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Pentoxifylline for treatment of sepsis and necrotizing enterocolitis in neonates.己酮可可碱用于治疗新生儿败血症和坏死性小肠结肠炎。
Cochrane Database Syst Rev. 2015 Mar 9(3):CD004205. doi: 10.1002/14651858.CD004205.pub3.