Antimicrobial utilization in very-low-birth-weight infants: association with probiotic use

Joseph Y Ting; Eugene W Yoon; Carlos A Fajardo; Thierry Daboval; Valérie Bertelle; Prakesh S Shah; Canadian Neonatal Network (CNN) Investigators

doi:10.1038/s41372-022-01382-w

Antimicrobial utilization in very-low-birth-weight infants: association with probiotic use

J Perinatol. 2022 Jul;42(7):947-952. doi: 10.1038/s41372-022-01382-w. Epub 2022 Apr 11.

Authors

Joseph Y Ting^{1

2}, Eugene W Yoon³, Carlos A Fajardo⁴, Thierry Daboval⁵, Valérie Bertelle⁶, Prakesh S Shah^{7

8}; Canadian Neonatal Network (CNN) Investigators

Collaborators

Canadian Neonatal Network (CNN) Investigators:
Prakesh S Shah, Marc Beltempo, Jaideep Kanungo, Jonathan Wong, Zenon Cieslak, Rebecca Sherlock, Ayman Abou Mehrem, Jennifer Toye, Joseph Y Ting, Carlos Fajardo, Jaya Bodani, Lannae Strueby, Mary Seshia, Deepak Louis, Ruben Alvaro, Amit Mukerji, Orlando Da Silva, Sajit Augustine, Kyong-Soon Lee, Eugene Ng, Brigitte Lemyre, Thierry Daboval, Faiza Khurshid, Victoria Bizgu, Keith Barrington, Anie Lapointe, Guillaume Ethier, Christine Drolet, Bruno Piedboeuf, Martine Claveau, Marie St-Hilaire, Valerie Bertelle, Edith Masse, Roderick Canning, Hala Makary, Cecil Ojah, Luis Monterrosa, Julie Emberley, Jehier Afifi, Andrzej Kajetanowicz, Shoo K Lee

Affiliations

¹ Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
² Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
³ Maternal-infant Care Research Centre, Mount Sinai Hospital, Toronto, ON, Canada.
⁴ Department of Pediatrics, University of Calgary, Calgary, AB, Canada.
⁵ Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada.
⁶ Department of Pediatrics, Université de Sherbrooke, Sherbrooke, QC, Canada.
⁷ Maternal-infant Care Research Centre, Mount Sinai Hospital, Toronto, ON, Canada. [email protected].
⁸ Department of Paediatrics, University of Toronto, Toronto, ON, Canada. [email protected].

PMID: 35399098
DOI: 10.1038/s41372-022-01382-w

Abstract

Objective: To examine the association between probiotic use and antimicrobial utilization.

Study design: We retrospectively evaluated very-low-birth-weight (VLBW) infants admitted to tertiary neonatal intensive care units in Canada between 2014 and 2019. Our outcome was antimicrobial utilization rate (AUR) defined as number of days of antimicrobial exposure per 1000 patient-days.

Result: Of 16,223 eligible infants, 7279 (45%) received probiotics. Probiotic use rate increased from 10% in 2014 to 68% in 2019. The AUR was significantly lower in infants who received probiotics vs those who did not (107 vs 129 per 1000 patient-days, aRR = 0.89, 95% CI [0.81, 0.98]). Among 13,305 infants without culture-proven sepsis or necrotizing enterocolitis ≥Stage 2, 5931 (45%) received probiotics. Median AUR was significantly lower in the probiotic vs the no-probiotic group (78 vs 97 per 1000 patient-days, aRR = 0.85, 95% CI [0.74, 0.97]).

Conclusion: Probiotic use was associated with a significant reduction in AUR among VLBW infants.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anti-Bacterial Agents
Enterocolitis, Necrotizing* / epidemiology
Enterocolitis, Necrotizing* / prevention & control
Humans
Infant
Infant, Newborn
Infant, Very Low Birth Weight
Probiotics* / therapeutic use
Retrospective Studies

Substances

Anti-Bacterial Agents

Grants and funding

CTP 87518/Gouvernement du Canada | Canadian Institutes of Health Research (Instituts de Recherche en Santé du Canada)