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Intestinal strictures linked to anaerobic antimicrobial therapy in infants with necrotizing enterocolitis

Tuesday, January 6, 2015
P. Brian Smith

Anaerobic antimicrobial therapy is associated with an increased risk of intestinal strictures in premature infants with necrotizing enterocolitis (NEC), although infants who underwent surgery for NEC have a slightly lower risk of death if they receive the therapy.

These findings, published recently in the journal Pediatrics, come from a study conducted by the DCRI’s Julie Autmizguine, MD, MHS; Christoph Hornik, MD, MPH; Daniel Benjamin Jr, MD, PhD, MPH; Michael Cohen-Wolkowiez, MD, PhD; P. Brian Smith, MD, MPH, MHS (pictured); and colleagues from other institutions. The study was conducted on behalf of the Best Pharmaceuticals for Children Act—Pediatric Trials Network Administrative Core Committee.

NEC, which occurs in approximately 10% of premature infants, is characterized by the inflammation and death of intestinal tissue. About 15% of infants with NEC will die of the condition, and for those who are treated with surgery, the rate rises to approximately 50%. NEC is typically treated with a variety of antibiotics and, in some cases, surgery. However, an earlier randomized trial suggested that anaerobic antimicrobial therapy was associated with increased risk of intestinal strictures. Strictures are intestinal obstructions resulting from wound healing, and are considered a marker of severity of NEC.

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