Less is more: Antibiotics at the beginning of life
Martin Stocker, Claus Klingenberg, Lars Navér, Viveka Nordberg, Alberto Berardi, Salhab el Helou, Gerhard Fusch, Joseph M. Bliss, Dirk Lehnick, Varvara Dimopoulou, Nicholas Guerina, Joanna Seliga‐Siwecka, Pierre Maton, Donatienne Lagae, Judit Mari, Jan Janota, Philipp Agyeman, Riccardo Pfister, Giuseppe Latorre, G Maffei, Nichola Laforgia, Enikő Mózes, Ketil Størdal, Tobias Strunk, Éric Giannoni
Abstract
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.