Pediatric Surgery International

, Volume 34, Issue 1, pp 35–45 | Cite as

The initial prophylactic antibiotic usage and subsequent necrotizing enterocolitis in high-risk premature infants: a systematic review and meta-analysis

  • Xue Fan
  • Li Zhang
  • Jun Tang
  • Chao Chen
  • Juan Chen
  • Yi Qu
  • Dezhi Mu
Original Article



To investigate the correlation between the initial prophylactic antibiotic use and the subsequent NEC in high-risk premature infants.


We performed a literature search of PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), and the Web of Science, and nine studies with a total of 5207 infants were selected for inclusion in this study.


The pooled estimate for the seven studies combined indicating that prophylactic antibiotic usage was associated with a non-significant trend toward increased incidence of NEC [odds ratio (OR) 0.75; 95% confidence interval (CI) 0.26–2.17], and prolonged exposure to prophylactic antibiotics, compared with limited prophylactic antibiotic use, was associated with a significant trend toward the risk of increasing incidence of NEC (OR 1.31; 95% CI 1.08–1.59).


Current evidence does not support the use of prophylactic antibiotics to reduce the incidence of NEC for high-risk premature infants.


NEC Antibiotic Prophylactic Premature infants Meta-analysis 



This work was supported by the National Natural Science Foundation of China (No. 81330016, 81630038, and 81300524), the National Key Research and Development Program (2017YFA0104200), the Major State Basic Research Development Program (2013CB967404, 2012BAI04B04), Grants from the Science and Technology Bureau of Sichuan province (2014SZ0149, 2016TD0002), and a Grant from the Clinical Discipline Program (Neonatology) from the Ministry of Health of China (1311200003303).

Author contributions

XF and LZ contributed equally to this report, XF and LZ designed the study and wrote the manuscript. CC and JC performed the literature searches and collected the data. YQ conducted the statistical analysis. JT and DM revised the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare no competing financial interests.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  • Xue Fan
    • 1
    • 2
  • Li Zhang
    • 1
    • 2
  • Jun Tang
    • 1
    • 2
  • Chao Chen
    • 1
    • 2
  • Juan Chen
    • 1
    • 2
  • Yi Qu
    • 1
    • 2
  • Dezhi Mu
    • 1
    • 2
  1. 1.Department of Pediatrics, West China Second University HospitalSichuan UniversityChengduChina
  2. 2.Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of EducationChengduChina

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