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Less is more: Antibiotics at the beginning of life.

Martin StockerClaus KlingenbergLars NavérViveka NordbergAlberto BerardiSalhab El HelouGerhard FuschJoseph M BlissDirk LehnickVarvara DimopoulouNicholas GuerinaJoanna P Seliga-SiweckaPierre MatonDonatienne LagaeJudit MariJan JanotaPhilipp Kwame Abayie AgyemanRiccardo E PfisterGiuseppe LatorreGianfranco MaffeiNichola LaforgiaEnikő MózesKetil StørdalTobias StrunkEric Giannoni
Published in: Nature communications (2023)
Antibiotic exposure at the beginning of life can lead to increased antimicrobial resistance and perturbations of the developing microbiome. Early-life microbiome disruption increases the risks of developing chronic diseases later in life. Fear of missing evolving neonatal sepsis is the key driver for antibiotic overtreatment early in life. Bias (a systemic deviation towards overtreatment) and noise (a random scatter) affect the decision-making process. In this perspective, we advocate for a factual approach quantifying the burden of treatment in relation to the burden of disease balancing antimicrobial stewardship and effective sepsis management.
Keyphrases
  • antimicrobial resistance
  • early life
  • decision making
  • acute kidney injury
  • intensive care unit
  • risk assessment
  • prefrontal cortex
  • combination therapy