Empirical Antibiotics in Non-Ventilated Cases of Meconium Aspiration Syndrome
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Purpose: Meconium aspiration is assumed to be a risk factor for bacterial infection, and patients with meconium aspiration syndrome (MAS) are commonly treated with empiric antibiotics in clinical settings. However, little is known about the effectiveness of the empirical antibiotics treatment. Here, we compared the short-term clinical outcomes associated with empirical antibiotics treatment in non-ventilated cases of MAS. Methods: A retrospective study was conducted on infants admitted with non-ventilated cases of MAS from March 2008 to September 2016. The infants enrolled in the study were divided into two groups based on the antibiotics treatment, and their clinical outcomes were compared. The incidence of sepsis during the hospitalization period and the incidence of delayed sepsis up to 3 months were evaluated. The effects of empirical antibiotic use on respiratory symptoms were evaluated, and the complications were compared. Results: A total of 109 infants were evaluated, of which 61 (56.0%) received antibiotics and 48 (44.0%) did not receive antibiotics. No differences in clinical characteristics were noted between the two groups. However, the empirical antibiotics group showed a significantly higher mean of respiratory rates, C-reactive protein levels, and positive rates, as well as a significantly longer hospitalization period. In clinical outcomes, there were no differences in sepsis rates or respiratory support duration. Furthermore, there were no differences in complications. Conclusion: The empirical use of antibiotics did not affect the clinical outcomes in cases of non-ventilated MAS. The role of empirical antibiotics in these infants may need to be reevaluated.
Abstract
Purpose: Meconium aspiration is assumed to be a risk factor for bacterial infection, and patients with meconium aspiration syndrome (MAS) are commonly treated with empiric antibiotics in clinical settings. However, little is known about the effectiveness of the empirical antibiotics treatment. Here, we compared the short-term clinical outcomes associated with empirical antibiotics treatment in non-ventilated cases of MAS. Methods: A retrospective study was conducted on infants admitted with non-ventilated cases of MAS from March 2008 to September 2016. The infants enrolled in the study were divided into two groups based on the antibiotics treatment, and their clinical outcomes were compared. The incidence of sepsis during the hospitalization period and the incidence of delayed sepsis up to 3 months were evaluated. The effects of empirical antibiotic use on respiratory symptoms were evaluated, and the complications were compared. Results: A total of 109 infants were evaluated, of which 61 (56.0%) received antibiotics and 48 (44.0%) did not receive antibiotics. No differences in clinical characteristics were noted between the two groups. However, the empirical antibiotics group showed a significantly higher mean of respiratory rates, C-reactive protein levels, and positive rates, as well as a significantly longer hospitalization period. In clinical outcomes, there were no differences in sepsis rates or respiratory support duration. Furthermore, there were no differences in complications. Conclusion: The empirical use of antibiotics did not affect the clinical outcomes in cases of non-ventilated MAS. The role of empirical antibiotics in these infants may need to be reevaluated.
참고문헌 (17)
- Cleary GM, "Meconium-stained amniotic fluid and the meconium aspiration syndrome", An update. Pediatr Clin North Am, 45, pp.511~529 (1998)
- Wiswell TE, "Meconium aspiration syndrome:have we made a difference?", Pediatrics, 85, pp.715~721 (1990)
- Bryan CS, "Enhancement of bacterial infections by meconium", Johns Hopkins Med J, 121, pp.9~13 (1967)
- Florman AL, "Enhancement of bacterial growth in amniotic fluid by meconium", J Pediatr, 74, pp.111~114 (1969)
- Blot P, "Fetal tachycardia and meconium staining: a sign of fetal infection", Int J Gynaecol Obstet, 21, pp.189~194 (1983)
- Romero R, "Meconium-stained amniotic fluid: a risk factor for microbial invasion of the amniotic cavity", Am J Obstet Gynecol, 164, pp.859~862 (1991)
- Craig S, "Meconium inhibits phagocytosis and stimulates respiratory burst in alveolar macrophages", Pediatr Res, 57, pp.813~818 (2005)
- Lee JS, "Manual of neonatal care", pp.383~387 (2008), Lippincott Williams & Wilkins
- Pi SY, "Manual of neonatal care", pp.201~204 (2014), The Korean Society of Neonatology
- Dargaville PA, "The epidemiology of meconium aspiration syndrome:incidence, risk factors, therapies, and outcome", Pediatrics, 117, pp.1712~1721 (2006)
- Goel A, "Role of prophylactic antibiotics in neonates born through meconium-stained amniotic fluid (MSAF): a randomized controlled trial", Eur J Pediatr, 174, pp.237~243 (2015)
- Eidelman AI, "The effect of meconium staining of amniotic fluid on the growth of Escherichia coli and group B streptococcus", J Perinatol, 22, pp.467~471 (2002)
- Schimmel MS, "Meconium stained amniotic fluid and bacterial growth a quantitative study", Pediatr Res, 39, pp.301~ (1996)
- Natarajan CK, "Surfactant therapy and antibiotics in neonates with meconium aspiration syndrome: a systematic review and meta-analysis", J Perinatol, 36, pp.S49~S54 (2016)
- Basu S, "Role of antibiotics in meconium aspiration syndrome", Ann Trop Paediatr, 27, pp.107~113 (2007)
- Lin HC, "Role of antibiotics in management of non-ventilated cases of meconium aspiration syndrome without risk factors for infection", Biol Neonate, 87, pp.51~55 (2005)
- Shankar V, "Do neonates with meconium aspiration syndrome require antibiotics?", Indian J Pediatr, 62, pp.327~331 (1995)