Keeping premature babies on antibiotics too long may raise superbug infection risks  

By | September 10, 2019

Antibiotics given to 80% of premature babies may alter their gut bacteria for DECADES – and leave them more vulnerable to superbugs, study finds

  • Researchers compared premature babies treated with antibiotics for 21 months to preemies treated for a week and untreated full-term babies
  • Heavily-treated infants had less diverse bacteria in their guts and, of what they did have, the species were often linked to disease
  • The bacteria also had more antibiotic-resistant genes, which could travel to other parts of the body and lead to deadly infections
  • At least 80% of premature infants are treated with antibiotics while in the NICU 

Most premature babies – about 80 percent – are given antibiotics in their first weeks of life to protect them from potentially fatal bacterial infections.

However, receiving this treatment for several months – even after they leave the NICU – may permanently alter their gut bacteria, a new study finds. 

Compared to babies that weren’t given antibiotics, the microbiomes of preemies had not only less diverse bacteria, but also more bacteria linked to antibiotic-resistance.

The team, from Washington University in St Louis School of Medicine, says its findings suggest that neonatologists should reduce their use of antibiotics in premature babies from a few months to just a few weeks. 

A new study from Washington University in St Louis School of Medicine has found that premature babies treated long-term with antibiotics had more gut bacteria with antibiotic-resistant genes (file image)

A new study from Washington University in St Louis School of Medicine has found that premature babies treated long-term with antibiotics had more gut bacteria with antibiotic-resistant genes (file image)

‘The immune system is pretty much set by age three,’ senior author Dr Gautam Dantas, a professor of pathology and immunology at Washington University, told DailyMail.com.

‘So changes in the first few weeks in life could be with you when you’re 18, 19 yrs old and that’s potentially setting people off on pretty different trajectories.’ 

For the study, published in Nature Microbiology, the team collected stool samples from 58 infants – 41 of whom were premature and 17 who were full-term. 

Of the premature infants, 32 received antibiotics for 21 months – both in the NICU and at home – and nine received antibiotics for less than a week.

None of the full-term were given antibiotics in the hospital or at home.

Researchers found that the infants who received the 21-month antibiotic treatment had less diverse bacteria in their guts than the other babies. 

The heavily-treated babies had fewer healthy kinds of bacteria such as Bifidobacteriaceae – which helps maintain a healthy colon – and more unhealthy types including Proteobacteria, which is linked to salmonella.

Moreover, these bacteria contained more antibiotic-resistant genes. 

The team says while this didn’t cause any immediate problems for the babies, it could cause long-term problems.

If gut microbes don’t remain in the intestine and make their way to the bloodstream, or other parts of the body, it can lead to infections that are difficult to treat.

‘For the most part, gut microbes are good,’ said Dr Dantas.

‘But they could get into the bloodstream and, even though we didn’t test for blood stream infections, it’s been shown that…they can be traced back to the gut.’

Co-author Dr Barbara Warner, director of the division of newborn medicine, says the findings have influenced her and her colleagues at St Louis Children’s Hospital to curtail their use of antibiotics in preemies. 

‘We’re no longer saying: ‘Let’s just start them on antibiotics because it’s better to be safe than sorry’,’ Dr Warner said. 

‘Now we know there’s a risk of selecting for organisms that can persist and create health risks later in childhood and in life.

‘So we’re being much more judicious about initiating antibiotic use, and when we do start babies on antibiotics, we take them off as soon as the bacteria are cleared.’  


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