Nature Communications (Apr 2023)
Less is more: Antibiotics at the beginning of life
- Martin Stocker,
- Claus Klingenberg,
- Lars Navér,
- Viveka Nordberg,
- Alberto Berardi,
- Salhab el Helou,
- Gerhard Fusch,
- Joseph M. Bliss,
- Dirk Lehnick,
- Varvara Dimopoulou,
- Nicholas Guerina,
- Joanna Seliga-Siwecka,
- Pierre Maton,
- Donatienne Lagae,
- Judit Mari,
- Jan Janota,
- Philipp K. A. Agyeman,
- Riccardo Pfister,
- Giuseppe Latorre,
- Gianfranco Maffei,
- Nichola Laforgia,
- Enikő Mózes,
- Ketil Størdal,
- Tobias Strunk,
- Eric Giannoni
Affiliations
- Martin Stocker
- Department of Pediatrics, Children’s Hospital Lucerne
- Claus Klingenberg
- Paediatric Research Group, Faculty of Health Sciences, UiT-The Arctic University of Norway
- Lars Navér
- Department of Neonatology, Karolinska University Hospital
- Viveka Nordberg
- Department of Neonatology, Karolinska University Hospital
- Alberto Berardi
- Neonatal Intensive Care Unit, Mother and Child Department, Policlinico University Hospital
- Salhab el Helou
- Division of Neonatology, Department of Pediatrics, McMaster Children’s Hospital, McMaster University, Hamilton Health Sciences
- Gerhard Fusch
- Division of Neonatology, Department of Pediatrics, McMaster Children’s Hospital, McMaster University, Hamilton Health Sciences
- Joseph M. Bliss
- Department of Pediatrics, Women & Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University
- Dirk Lehnick
- Biostatistics and Methodology, CTU-CS, Department of Health Sciences and Medicine, University of Lucerne
- Varvara Dimopoulou
- Clinic of Neonatology, Department Mother-Woman-Child, Lausanne University Hospital and University of Lausanne
- Nicholas Guerina
- Department of Pediatrics, Women & Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University
- Joanna Seliga-Siwecka
- Department of Neonatology and Neonatal Intensive Care, Medical University of Warsaw
- Pierre Maton
- Service néonatal, Clinique CHC-Montlegia, groupe santé CHC
- Donatienne Lagae
- Neonatology and Neonatal Intensive Care Unit, CHIREC-Delta Hospital
- Judit Mari
- Department of Paediatrics, University of Szeged
- Jan Janota
- Neonatal Unit, Department of Obstetrics and Gynecology, Motol University Hospital Prague
- Philipp K. A. Agyeman
- Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern
- Riccardo Pfister
- Neonatology and Paediatric Intensive Care Unit, Geneva University Hospitals and Geneva University
- Giuseppe Latorre
- Neonatology and Neonatal Intensive Care Unit, Ecclesiastical General Hospital F. Miulli
- Gianfranco Maffei
- Neonatology and Neonatal Intensive Care Unit, Policlinico Riuniti Foggia
- Nichola Laforgia
- Neonatologia e Terapia Intensiva Neonatale, University of Bari
- Enikő Mózes
- Perinatal Intensive Care Unit, Department of Obstetrics and Gynaecology, Semmelweis University
- Ketil Størdal
- Institute of Clinical Medicine, University of Oslo and Oslo University Hospital
- Tobias Strunk
- Neonatal Directorate, Child and Adolescent Health Service, King Edward Memorial Hospital
- Eric Giannoni
- Clinic of Neonatology, Department Mother-Woman-Child, Lausanne University Hospital and University of Lausanne
- DOI
- https://doi.org/10.1038/s41467-023-38156-7
- Journal volume & issue
-
Vol. 14,
no. 1
pp. 1 – 9
Abstract
Abstract Antibiotic exposure at the beginning of life can lead to increased antimicrobial resistance and perturbations of the developing microbiome. Early-life microbiome disruption increases the risks of developing chronic diseases later in life. Fear of missing evolving neonatal sepsis is the key driver for antibiotic overtreatment early in life. Bias (a systemic deviation towards overtreatment) and noise (a random scatter) affect the decision-making process. In this perspective, we advocate for a factual approach quantifying the burden of treatment in relation to the burden of disease balancing antimicrobial stewardship and effective sepsis management.
