We sought to evaluate postoperative antibiotic practices in a large population of patients with necrotizing enterocolitis (NEC) and determine whether any regimens were associated with better outcomes. The Pediatric Health Information Systems (PHIS) database was queried to identify patients who underwent an intestinal resection for acute NEC between July, 2016 and June, 2021. Data regarding post-resection antibiotic therapy, cutaneous or intraabdominal infection, and fungal or antibiotic-resistant infection were collected. 130 infants at 38 children's hospitals met inclusion criteria. Postoperative antibiotics were administered for a median of 13 days. The most frequently used antibiotics were vancomycin and piperacillin/tazobactam. Antibiotic duration greater than five days was not associated with a lower incidence of infection. No antibiotic was associated with a lower incidence of any of the complications assessed, although ampicillin was associated with more infections, overall. The incidence of fungal infection and treatment with a parenteral anti-fungal medication was greater with vancomycin. No antibiotic combination was used enough to be assessed. Administration of antibiotics for more than five days after resection for NEC was not associated with better infectious outcomes and no single antibiotic demonstrated superior efficacy. Consistent with prior studies, fungal infections were more frequent with vancomycin. Retrospective database study, level 3B. II.

中文翻译：

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抗生素策略对手术治疗坏死性小肠结肠炎结果的影响

我们试图评估大量坏死性小肠结肠炎 (NEC) 患者的术后抗生素使用情况，并确定是否有任何治疗方案与更好的结果相关。查询儿科健康信息系统 (PHIS) 数据库以确定 2016 年 7 月至 2021 年 6 月期间因急性 NEC 接受肠切除术的患者。有关切除后抗生素治疗、皮肤或腹内感染以及真菌或抗生素耐药性的数据收集感染。 38 家儿童医院的 130 名婴儿符合纳入标准。术后抗生素使用时间中位数为 13 天。最常用的抗生素是万古霉素和哌拉西林/他唑巴坦。抗生素使用时间超过五天与较低的感染发生率无关。总体而言，尽管氨苄西林与更多感染相关，但没有任何抗生素与所评估的任何并发症发生率降低相关。使用万古霉素时，真菌感染和肠外抗真菌药物治疗的发生率更高。没有使用足够的抗生素组合来进行评估。 NEC 切除后使用抗生素超过五天与更好的感染结果无关，并且没有任何一种抗生素表现出优越的疗效。与之前的研究一致，使用万古霉素时真菌感染更常见。回顾性数据库研究，3B 级。二.