A neonatologist may be tempted to prescribe a more prolonged course of antibiotics out of fear that the infant may have an infection. To be cautious, she overtreats. These new data suggest that this practice can actually do harm. This is another reason not to overtreat.
It is reasonable to infer that the treating physician had seen something in some of these children to prompt the longer duration of treatment. The infant must have somehow seemed sicker. The physician may have been concerned that if antibiotic treatment stopped sooner, the neonate's condition would have worsened. The optimal duration of treatment is always something to think about.
It is plausible that just a few extra days of antibiotic treatment can make an important difference. A 2-day duration of treatment probably does not change the background flora in the esophagus as much as a 7-day course. Longer exposure to antibiotics can result in a higher rate of fungal infection, which can trigger increased inflammation.
RITA M. RYAN, M.D., is chief of neonatology at the Women & Children's Hospital of Buffalo (N.Y.). She made these comments in an interview. She said that she had no relevant financial disclosures.