Patient selection: gestational age <= 32 weeks with birth weight <= 1,500 grams, surviving 7 days free of sepsis and necrotizing enterocolitis
Antibiotic therapy was prolonged if it was given for >= 5 days.
Complications of prolonged antibiotic therapy:
(1) late onset neonatal sepsis (LOS)
(2) necrotizing enterocolitis
(3) death
The odds ratio for a complication in a patient receiving prolonged antibiotic therapy was about 2.5.
Empiric antibiotic therapy is reasonable in this patient population but should not be prolonged if:
(1) cultures are negative with adequate sampling OR no clinical suspicion of sepsis if inadequate sampling performed
(2) the neonate is otherwise at low risk for sepsis
Additional complications may include:
(1) increased risk of infection with an antibiotic resistant bacteria or fungus
(2) antibiotic-associated toxicity
