Antibiotic duration and gastric dysmotility in preterm neonates

J Pediatr Gastroenterol Nutr. 2024 Sep;79(3):533-540. doi: 10.1002/jpn3.12235. Epub 2024 May 6.

Abstract

Objectives: Prolonged antibiotic use after birth is associated with neonatal feeding intolerance and functional gastrointestinal disorders (FGIDs). A gastric dysrhythmia (tachygastria) with frequencies >4-9 cycles per minute, measured by electrogastrography (EGG), is associated with FGIDs. The relationship between prolonged antibiotic use and % time spent in tachygastria is unknown in preterm infants. We aimed to compare weekly changes in % tachygastria between preterm infants receiving long (>48 h) versus short (≤48 h) courses of antibiotics for early onset sepsis evaluation (initiated at <3 days of life).

Methods: This was a longitudinal, prospective cohort study of 88 preterm infants (<34 weeks' gestation) with weekly EGG recordings from the first week of life until 40 weeks' post-menstrual age, discharge, or death. We calculated % of EGG recording time in tachygastria and determined the mean across weekly sessions. A mixed effects model assessed variance in % tachygastria between the short- and long-antibiotic exposure groups across all weeks.

Results: Baseline characteristics were similar between the two groups. There was no difference in % tachygastria between short and long antibiotic exposure groups across nine postnatal weeks (p = 0.08).

Conclusions: Early, prolonged antibiotic exposure among preterm infants may not lead to significant gastric dysrhythmia. Future studies including larger sample sizes and a "no antibiotic" exposure arm are essential in elucidating this potential relationship.

Keywords: electrogastrography; gastric myoelectrical activity; motility; premature; tachygastria.

MeSH terms

  • Anti-Bacterial Agents* / administration & dosage
  • Female
  • Gastrointestinal Motility* / drug effects
  • Humans
  • Infant, Newborn
  • Infant, Premature*
  • Infant, Premature, Diseases
  • Longitudinal Studies
  • Male
  • Prospective Studies
  • Time Factors

Substances

  • Anti-Bacterial Agents