抗生素治疗坏死性小肠结肠炎的持续时间存在差异，且对大型多中心队列的结局有影响。
Variability in antibiotic duration for necrotizing enterocolitis and outcomes in a large multicenter cohort.
机构信息
CHOC Children's Hospital, Orange, CA, USA.
Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.
出版信息
J Perinatol. 2022 Nov;42(11):1458-1464. doi: 10.1038/s41372-022-01433-2. Epub 2022 Jun 27.
OBJECTIVES
To evaluate variability in antibiotic duration for necrotizing enterocolitis (NEC) and associated clinical outcomes.
STUDY DESIGN
Five-hundred ninety-one infants with NEC (315 medical; 276 surgical) were included from 22 centers participating in Children's Hospitals Neonatal Consortium (CHNC). Multivariable analyses were used to determine predictors of variability in time to full feeds (TFF) and length of stay (LOS).
RESULTS
Median (IQR) antibiotic duration was 12 (9, 17) days for medical and 17 (14, 21) days for surgical NEC. Wide variability in antibiotic use existed both within and among centers. Duration of antibiotic therapy was associated with longer TFF in both medical (OR 1.04, 95% CI [1.01, 1.05], p < 0.001) and surgical NEC (OR 1.02 [1, 1.03] p = 0.046); and with longer LOS in medical (OR 1.03 [1.02, 1.04], p < 0.001) and surgical NEC (OR 1.01 [1.01, 1.02], p = 0.002).
CONCLUSION
Antibiotic duration for both medical and surgical NEC remains variable within and among high level NICUs.
目的
评估坏死性小肠结肠炎（NEC）抗生素持续时间的变异性及其与临床结局的关系。
研究设计
从参与儿童医院新生儿联盟（CHNC）的 22 个中心纳入了 591 例 NEC 婴儿（315 例内科；276 例外科）。采用多变量分析来确定全肠喂养时间（TFF）和住院时间（LOS）变异性的预测因素。
结果
内科 NEC 的抗生素疗程中位数（IQR）为 12（9，17）天，外科 NEC 为 17（14，21）天。内科和外科 NEC 中都存在抗生素使用的广泛变异性。抗生素治疗持续时间与 TFF 延长有关，在内科 NEC 中呈剂量依赖性（OR 1.04，95%CI [1.01, 1.05]，p<0.001），在外科 NEC 中也呈剂量依赖性（OR 1.02 [1, 1.03]，p=0.046）；与 LOS 延长有关，在内科 NEC 中呈剂量依赖性（OR 1.03 [1.02, 1.04]，p<0.001），在外科 NEC 中也呈剂量依赖性（OR 1.01 [1.01, 1.02]，p=0.002）。
结论
内科和外科 NEC 的抗生素疗程在高水平 NICU 内和之间仍然存在差异。
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