Antibiotic utilisation in very low birth weight infants without sepsis or necrotising enterocolitis is associated with multiple adverse outcomes.

Commentary on: Ting JY, Synnes A, Roberts A, et al . Association Between Antibiotic Use and Neonatal Mortality and Morbidities in Very Low-Birth-Weight Infants Without Culture-Proven Sepsis or Necrotizing Enterocolitis. JAMA Pediatr . 2016;170:1181–1187. Concerns about antibiotic overuse have been raised since the 1940s, largely driven by worries about antibiotic resistance and the limited development pipeline for new antimicrobials.1 More recently, prolonged antibiotic exposure has been associated with adverse outcomes in preterm infants, including sepsis, necrotising enterocolitis and mortality.2 3 Paralleling these findings has been the rapid increase in our knowledge of the importance of the gut microbiome in health and disease,4 one that is substantially altered in infancy by antimicrobial exposure.5 Understanding the relationship between antimicrobial …