Use (and abuse) of antibiotics in perinatal medicine

Cardetti, Marcelo; Ochoa-Rodríguez, Susana; Sola, Augusto

doi:10.1016/j.anpede.2020.08.003

Cited by 5 publications

(4 citation statements)

References 43 publications

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“…Except where a prescription is indicated, the rationale to routinely and preemptively give these antibiotics shortly after birth is speculative rather than evidence based, and includes the possibility that preterm delivery may have been caused by infection in the mother, such as chorioamnionitis. (Cardetti et al, 2020). Moreover, compared with preterm infants who were not exposed to antibiotics, those exposed had high rates of NEC, sepsis, and death (Greenwood et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

The impact of neonatal intensive care unit antibiotics on gut bacterial microbiota of preterm infants: a systematic review

Mulinge,

Mwanza,

Kabahweza

et al. 2023

Front. Microbiomes

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Preterm infants encounter an unnatural beginning to life, with housing in neonatal intensive care units (NICUs) where they are exposed to antibiotics. Although the effectiveness of antibiotics in infection control is well established, the short- and long-term unintended effects on the microbiota of preterm infants receiving antibiotic treatment are yet to be quantified. Our aim was to investigate the unintended consequences of NICU antibiotics on preterm infants’ gut microbiota. We searched three electronic databases—Embase, PubMed, and Scopus—for records from 2010 to October 2022. Eligibility criteria included intervention and observational studies that collected stool samples and analyzed microbiota data on the effect of antibiotics on the gut microbiota of preterm infants using 16S rRNA sequencing. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and the quality of the studies was judged using the Cochrane Collaboration Tool for assessing risk of bias (RoB2) for clinical trials, while non-randomized studies were assessed using the Newcastle–Ottawa Scale (NOS). The initial searches yielded 7,605 papers, of which 21 were included in the review. The selected studies examined 3,669 stool samples that were collected longitudinally from 878 preterm infants in seven different countries. Preterm infants exposed to antibiotics had a reduced bacterial diversity, an increased relative abundance of pathogenic bacteria such as Enterobacteriaceae, and a decrease or absence of symbiotic bacteria such as Bifidobacterium spp., which have been shown to assist in immunity development. Antibiotic discontinuation restored diversity, with variances linked to the antibiotic spectrum and treatment duration in some but not all cases. Breastfeeding confounded the association between antibiotic use and dysbiosis. Intriguingly, the reduction of γ-aminobutyric acid (GABA), a crucial neurotransmitter for early brain development, was linked to the depletion of Veillonella spp. Despite the apparent benefits of using antibiotics on preterm infants, we conclude that they should be used only when absolutely necessary and for a short period of time. Mothers’ milk is recommended to hasten the restoration of disrupted microbiota.

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Section: Discussionmentioning

confidence: 99%

The impact of neonatal intensive care unit antibiotics on gut bacterial microbiota of preterm infants: a systematic review

Mulinge,

Mwanza,

Kabahweza

et al. 2023

Front. Microbiomes

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“…One of the biggest challenges to modern public health is antimicrobial resistance (AMR). It has been promoted by increased exposure and the misuse of antibiotics [ 7 , 8 ]. According to the UK Government-commissioned Review on AMR, it might kill 10 million people annually by 2050.…”

Section: Introductionmentioning

confidence: 99%

Zinc Oxide Nanoparticles Promise Anticancer and Antibacterial Activity in Ovarian Cancer

et al. 2023

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Background Ovarian cancer is the most lethal cancer in gynaecology. Surgery, chemotherapy, and radiotherapy are the most often used cancer-fighting strategies. Post-surgery infection is fairly prevalent, especially among people with insufficient immunity. Zinc oxide nanoparticles (ZnOnps) have amazing biomedical features as anticancer and antibacterial agents. Methods We investigated the behaviour of ZnOnps synthesized by green methods on ovarian cancers using established human ovarian cancer cell lines, besides the antibacterial action toward models of gram + ve and gram -ve bacteria. The cytotoxic effect of ZnOnps was calculated using a Sulforhodamine B (SRB) trial. Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) were tested as models for gram + ve and gram -ve bacteria. The selected bacteria were subjected to concentrations of 20, 40, 80, and 100 μg/ml. Results The synthesized ZnOnps induced 50% inhibitory concentration (IC50) at a concentration of 27.45 μg/ml. The diameter of inhibition ranged between 20.16 ± 0.16 and 27 ± 0.57 mm for S. aureus and 25.66 ± 0.33 to 31 ± 0.33 mm for E. coli. ZnOnps antagonistic effect statistically differed with neomycin, cefaclor, and cefadroxil. Conclusions Green synthesis of ZnOnps is easily prepared, low cost, non-toxic, and eco-friendly. Their cytotoxic action on SKOV3 cells and their antibacterial characteristics pave the way to be an alternative therapy for ovarian cancer and S. aureus and E. coli infection.

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“…Maternal antibiotics often coincided with the perinatal period to prevent infectious morbidity and mortality ( Cardetti et al, 2020 ; Thinkhamrop et al, 2021 ) and postpartum infection after post-surgical C-section complications ( O’Connor et al, 2021 ). While the administration of antibiotics is maybe critical to maintaining maternal health during pregnancy, registry-based cohort studies demonstrated that maternal antibiotics exacerbate the risks of developing asthma and early-onset sepsis in their children ( Stokholm et al, 2014 ; Zhou et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Maternal antibiotic administration during gestation can affect the memory and brain structure in mouse offspring

Shepilov,

Osadchenko,

Kovalenko

et al. 2023

Front. Cell. Neurosci.

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Maternal antibiotics administration (MAA) is among the widely used therapeutic approaches in pregnancy. Although published evidence demonstrates that infants exposed to antibiotics immediately after birth have altered recognition memory responses at one month of age, very little is known about in utero effects of antibiotics on the neuronal function and behavior of children after birth. Therefore, this study aimed to evaluate the impact of MAA at different periods of pregnancy on memory decline and brain structural alterations in young mouse offspring after their first month of life. To study the effects of MAA on 4-week-old offspring, pregnant C57BL/6J mouse dams (2–3-month-old; n = 4/group) were exposed to a cocktail of amoxicillin (205 mg/kg/day) and azithromycin (51 mg/kg/day) in sterile drinking water (daily/1 week) during either the 2nd or 3rd week of pregnancy and stopped after delivery. A control group of pregnant dams was exposed to sterile drinking water alone during all three weeks of pregnancy. Then, the 4-week-old offspring mice were first evaluated for behavioral changes. Using the Morris water maze assay, we revealed that exposure of pregnant mice to antibiotics at the 2nd and 3rd weeks of pregnancy significantly altered spatial reference memory and learning skills in their offspring compared to those delivered from the control group of dams. In contrast, no significant difference in long-term associative memory was detected between offspring groups using the novel object recognition test. Then, we histologically evaluated brain samples from the same offspring individuals using conventional immunofluorescence and electron microscopy assays. To our knowledge, we observed a reduction in the density of the hippocampal CA1 pyramidal neurons and hypomyelination in the corpus callosum in groups of mice in utero exposed to antibiotics at the 2nd and 3rd weeks of gestation. In addition, offspring exposed to antibiotics at the 2nd or 3rd week of gestation demonstrated a decreased astrocyte cell surface area and astrocyte territories or depletion of neurogenesis in the dentate gyrus and hippocampal synaptic loss, respectively. Altogether, this study shows that MAA at different times of pregnancy can pathologically alter cognitive behavior and brain development in offspring at an early age after weaning.

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Use (and abuse) of antibiotics in perinatal medicine

Cited by 5 publications

References 43 publications

The impact of neonatal intensive care unit antibiotics on gut bacterial microbiota of preterm infants: a systematic review

The impact of neonatal intensive care unit antibiotics on gut bacterial microbiota of preterm infants: a systematic review

Zinc Oxide Nanoparticles Promise Anticancer and Antibacterial Activity in Ovarian Cancer

Maternal antibiotic administration during gestation can affect the memory and brain structure in mouse offspring

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