ANTIBIOTICS: To Give or Not To Give?

22 Apr

One of the most common problem in the newborn is infection. As a matter of fact, the WHO 2008 data on causes of death among under 5 years old lists infection as one of the top 3 leading causes. The problem is that there is no one single manifestation that is pathognomonic for it; also it may mimic other conditions besetting the newborn. There is diagnostic dilemma and that waiting for the occurrence of symptoms first before beginning treatment may already be late. Guideline in the management of infection vary from one institution to another.  The best approach is to identify risk factors from the maternal history and the physical attributes of the newborn at birth. However, often than not, even maternal history might not be helpful in some instances and cloud the judgement.


(WHO Causes of Mortality in Under 5 – 2008)

Many newborn care providers are confused as far as dealing with newborns with suspected or definite infection is concerned. Other caregivers are overzealous in their approach such that babies who don’t need antibiotics at all are unnecessarily began with. Is there a danger of starting babies on antibiotics?

American Journal of Epidemiology has reported a result of a cohort study on December 2010 where antibiotics exposure by age 6 months is linked to asthma and allergy by 6 years old. According to senior author Michael B. Bracken, professor of Epidemiology at Yale University School of Public Health in New Haven, Connecticut, “early antibiotic exposure, especially broad-spectrum antibiotics, may suppress the developing immune system and produce a reduced anti-allergic response.” Infants with asthma were excluded in the study. The study found out that those infants who have no family history of asthma, after exposure to antibiotics, have a stronger risk of developing asthma by age 6 years old. The risk for atopic asthma and allergic asthma was also increased.

This should alert pediatric caregivers to use antibiotics conscientiously. Indication of antibiotic use should be ascertained meticulously so as to avoid the infant’s unnecessary exposure, and thus avoiding this increased risk to developing allergic disorders.

(The abstract of the study may be read on this link:

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Posted by on April 22, 2012 in Infection, neonates


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