Chetta Katherine E, Vincent Katherine G, Fanning Bresney, Klumb Ashley B, Chetta Justin A, Rohrer Allison M, Spence Leslie H, Hill Jeanne G
Division of Neonatology, Department of Pediatrics, Medical University of South Carolina, 10 McClennan Banks Drive, Charleston, SC 29425, USA.
Department of Neuroradiology, Medical University of South Carolina, 96 Jonathan Lucas Street MSC 323, Charleston, SC 29425, USA.
Children (Basel). 2023 Jan 14;10(1):160. doi: 10.3390/children10010160.
This study investigated whether delayed receipt of antibiotics in infants with necrotizing enterocolitis (NEC) is associated with disease severity. In this retrospective, single-center cohort study of infants diagnosed with NEC over 4 years, we compared the timing of antibiotic administration in infants (time order placed to time of receipt) in medical and surgical NEC. Cases were independently reviewed, then various clinical factors were compared. Of 46 suspected cases, 25 were confirmed by a panel of radiologists with good interrater reliability (ICC 0.657; p < 0.001). Delays in antibiotic receipt were 1.7× greater in surgical than medical NEC cases (p = 0.049). Every hour after order entry increased the adjusted odds of surgical NEC by 2.4 (1.08−5.23; p = 0.032). Delayed antibiotic receipt was more common in infants with surgical than medical NEC. Larger studies will be needed to investigate if optimizing antibiotic expediency could improve intestinal outcomes.
本研究调查了坏死性小肠结肠炎（NEC）婴儿延迟使用抗生素是否与疾病严重程度相关。在这项对4年间诊断为NEC的婴儿进行的回顾性单中心队列研究中，我们比较了内科和外科NEC婴儿中抗生素给药的时间（从医嘱下达时间到用药时间）。对病例进行独立审查，然后比较各种临床因素。在46例疑似病例中，25例经一组放射科医生确诊，组内可靠性良好（组内相关系数ICC 0.657；p<0.001）。外科NEC病例中抗生素延迟使用的情况比内科NEC病例多1.7倍（p = 0.049）。医嘱下达后每过一小时，外科NEC的校正比值比增加2.4（1.08 - 5.23；p = 0.032）。外科NEC婴儿比内科NEC婴儿更常出现抗生素延迟使用的情况。需要开展更大规模的研究来调查优化抗生素使用及时性是否能改善肠道预后。
