The initial prophylactic antibiotic usage and subsequent necrotizing enterocolitis in high-risk premature infants: a systematic review and meta-analysis.

OBJECTIVE: To investigate the correlation between the initial prophylactic antibiotic use and the subsequent NEC in high-risk premature infants.

METHODS: We performed a literature search of PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), and the Web of Science, and nine studies with a total of 5207 infants were selected for inclusion in this study.

RESULTS: The pooled estimate for the seven studies combined indicating that prophylactic antibiotic usage was associated with a non-significant trend toward increased incidence of NEC [odds ratio (OR) 0.75; 95% confidence interval (CI) 0.26-2.17], and prolonged exposure to prophylactic antibiotics, compared with limited prophylactic antibiotic use, was associated with a significant trend toward the risk of increasing incidence of NEC (OR 1.31; 95% CI 1.08-1.59).

CONCLUSION: Current evidence does not support the use of prophylactic antibiotics to reduce the incidence of NEC for high-risk premature infants.