To retrospectively study the use of antibiotics among neonates with a gestational age of ≥ 35 weeks experiencing respiratory distress,and to identify the risk factors associated with antibiotic use

Abstract

Background

Respiratory distress is a common reason for NICU admission among late preterm and term neonates. Antibiotic use is prevalent among these neonates requiring respiratory support. This study investigates antibiotic use and its associated risk factors.

Methods

A retrospective study was conducted at Al Wakra Hospital, Qatar, from January to December 2022. Neonates born at 35 weeks gestation or more, admitted to the NICU with respiratory distress, and requiring respiratory support were included based on specific criteria.

Results

Of the 1194 neonates admitted to the NICU, 1062 were 35 weeks or more gestational age. Among these, 485 neonates developed respiratory distress requiring respiratory support, with 442 included in the final analysis. Antibiotics were used in 56.1% (248/442) of cases. Factors such as maternal age, parity, rupture of membranes, chorioamnionitis, group B streptococci, antenatal prophylactic antibiotics, mode of delivery, sex, fetal distress, meconium-stained amniotic fluid, need for resuscitation, Apgar score ≤7 at 5 minutes, age at NICU admission, duration of NICU admission, maximum respiratory support, and duration of respiratory support were significantly associated with antibiotic use. Regression analysis identified parity, gestational age, sex, meconium-stained amniotic fluid, and duration of respiratory support as significant predictors of antibiotic use.

Conclusions

Respiratory distress leads to frequent NICU admissions among late preterm and term neonates, with 56.1% receiving antibiotics. To mitigate potential harm from antibiotic exposure, strategies to reduce use without increasing neonatal sepsis risk are essential.