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Aminoglycosides were associated with higher rates of surgical patent ductus arteriosus closure in preterm infants
Author(s) -
Marissen Janina,
Erdmann Harald,
Böckenholt Kai,
Hoppenz Marc,
Rausch Tanja K.,
Härtel Christoph,
Herting Egbert,
Göpel Wolfgang
Publication year - 2021
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.15541
Subject(s) - medicine , ductus arteriosus , gentamicin , intensive care , gestational age , retinopathy of prematurity , antibiotics , neonatology , exact test , neonatal intensive care unit , pediatrics , anesthesia , intensive care medicine , pregnancy , genetics , microbiology and biotechnology , biology
Abstract Aim In animal studies, aminoglycosides induced ductus arteriosus relaxation in a dose‐dependent fashion. We tested the hypothesis that antibiotic treatment of preterm infants with aminoglycosides is associated with higher rates of surgical patent ductus arteriosus (PDA) closure. Methods Preterm infants (birthweight <1000 grams or gestational age <29 weeks) enrolled in 62 German neonatal intensive care units (NICUs) were analysed. NICUs were stratified according to the use of aminoglycosides as first‐line antibiotics. Results Baseline data were not different when NICUs using aminoglycosides (n = 9965 infants) were compared to NICUs using other antibiotics (n = 1948 infants). Rates of surgical PDA closure were 5.9% for NICUs using aminoglycosides; 6.2% for units using gentamicin; and 5.0% for NICUs using tobramycin compared to 4.1% in NICUs using other antibiotics ( P < .001, P < .001 and P = .140, respectively, Fisher's exact test). Indomethacin and ibuprofen use was more common in NICUs using aminoglycosides (41% vs 33%, P < .001, Fisher's exact test). Gentamicin trough levels were higher in NICUs with surgical closure rates above the mean (median 2.0 µg/mL, inter‐quartile range 0.8‐4.0 µg/mL vs 1.2 µg/mL, IQR 0.8‐1.7, P < .001, Mann‐Whitney U test). Conclusion First‐line antibiotic treatment of preterm infants with aminoglycosides was associated with higher rates of surgical PDA closure.