Abstract

Abstract Aim To determine the association between the duration and types of antibiotic exposure and the occurrence of short‐ and long‐term outcomes among preterm, very‐low‐birthweight (VLBW) infants. Methods Retrospective cohort study of VLBW infants born <32 weeks gestation between January 2017–December 2021. Association between antibiotic exposure and the occurrence of death and/or major morbidities, and neurodevelopmental impairment (NDI) at 18–24 months corrected age, was evaluated. Results A total of 728 infants were included—median gestation 28 weeks (IQR 26, 30) and median birthweight 1070g (IQR 850, 1300). Compared to no antibiotics, antibiotics exposure >3 days was significantly associated with increased risk of mortality and/or bronchopulmonary dysplasia (BPD)—adjusted odds ratio (AOR) 2.0 (95% CI 1.1–3.8; p =0.03), 3.5 (95% CI 1.6–7.8; p =0.01) and 3.8 (95% CI 1.6‐9.0; p <0.001) corresponding to antibiotic exposure of 4‐7 days, 8–14 and >14 days, respectively. Additional exposure to broad‐spectrum antibiotics was associated with AOR of 3.2 (95% CI 1.6–6.5; p <0.01) for death and/or BPD. There was no significant association between antibiotic exposure and NDI. Conclusion Infants who received >3 days of antibiotics and/or additional broad‐spectrum antibiotics had significantly increased odds of death and/or BPD compared to no exposure. Antibiotic exposure was not significantly associated with NDI in our population.