By: Barrie Quappé RN, BSN – Consultant/Director:
The use of antibiotics has been seen to cause a plethora of other conditions, the most reported being the adaptations of germs that render them ineffective and the increase in ‘super bugs’. This is a phenomenon that every hospital and even some mid-size clinics should be on the look-out for and ensure their infection control policies are monitoring this possibility fervently.
For the newborn there is a nightmare that could unfold that practitioners need to be vigilant in their prevention efforts.
“While the survival of extremely premature infants with respiratory distress syndrome has increased due to advanced respiratory care in recent years, necrotizing enterocolitis (NEC) remains the leading cause of neonatal mortality and morbidity.” (Choi, 2014)
While breastfeeding and administration of probiotics have been established as ways to reduce the incidence there is still no firm pathway for prevention or cure of this often fatal condition. There should be further investigation into prevention methodologies but for now we all should remain vigilant of this condition that targets low birth weight babies. In another study, it was found that administration of antibiotics and hospital care can contribute to the inflammatory cascade that often proves to be fatal.
“Although differences in microbiota between preterm and full-term infants and adults could be developmentally based, it is likely that factors in the hospital environment or NICU practice influence microbiota development. Furthermore, limited microbiota diversity among preterm infants may render the microbiota more susceptible to perturbations introduced by clinical care or environmental conditions. Our results raise the possibility that decreased microbial diversity caused by administration of antibiotics predisposes to NEC. Breast milk feeding and probiotics have been shown to alter intestinal flora and decrease the incidence of NEC.” (Lucas and Cole, 1990; Hoyos, 1999; Harmsen et al., 2000; Bin-Nun et al., 2005; Lin et al., 2005 as cited in Wang et al, 2009)
There is nothing more devastating to a family than having a successful birth of a new member of your family, only to lose them within days of their birth. We must stay alert to this beast.
- Choi, Y.Y. (2014) ‘Necrotizing enterocolitis in newborns: update in pathophysiology and newly emerging therapeutic strategies’, Korean Journal of Pediatrics 57(12) pp. 505–513 – http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4316593/
- Wang, Y., Hoenig, J.D., Malin, K.J., Qamar, S., Petrof, E.O., Sun, J., Antonopoulos, D.A., Chang, E.B. & Claud, E.C.,(2009) ‘16S rRNA gene-based analysis of fecal microbiota from preterm infants with and without necrotizing enterocolitis’, ISME Journal 3, pp. 944-954 – http://www.nature.com.liverpool.idm.oclc.org/ismej/journal/v3/n8/full/ismej200937a.html