To examine the association between probiotic use and antimicrobial utilization.
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.
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]).
Probiotic use was associated with a significant reduction in AUR among VLBW infants.
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The authors thank all site investigators and data abstractors of the Canadian Neonatal Network (CNN). A list of participating CNN site investigators and their affiliations is presented in the Supplementary Infromation. We thank the staff at the Maternal-infant Care Research Centre (MiCare) at Mount Sinai Hospital in Toronto, Ontario, Canada, for organizational support of the CNN. In particular, we thank Heather McDonald Kinkaid, PhD, a scientific writer at MiCare, for editorial support in preparing this paper.
Although no specific funding was received for this study, organizational support for the Canadian Neonatal Network was provided by the Maternal-infant Care Research Centre (MiCare) at Mount Sinai Hospital in Toronto, Ontario, Canada. MiCare is supported by the Canadian Institutes of Health Research (CTP 87518), the Ontario Ministry of Health and Long-Term Care, and Mount Sinai Hospital. Dr JYT receives salary support from the Investigator Grant Award Program of the British Columbia Children’s Hospital Research Institute.
The authors declare no competing interests.
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Ting, J.Y., Yoon, E.W., Fajardo, C.A. et al. Antimicrobial utilization in very-low-birth-weight infants: association with probiotic use. J Perinatol 42, 947–952 (2022). https://doi.org/10.1038/s41372-022-01382-w