Systematic Evaluation of Risk Factors for Antibiotic-associated Diarrhea in Chinese Nneonates

OBJECTIVE To evaluate the risk factors for antibiotic-associated diarrhea(AAD) in Chinese neonates. METHODS The related databases of PubMed,Embase,CNKI,VIP,CBM,and Wanfang were electronically searched for the case-control studies about risk factors for AAD in neonates from database building to March 2018. The quality of the literature evaluated by Newcastle Ottawa Scale,and then meta-analysis was conducted using RevMan 5.2 software. RESULTS Total of 15 studies involving and 6 838 patients were entered, including 1 038 in the AAD group and 5 800 in the non-AAD group. The result of meta analysis showed that invasive operation(OR=3.70, 95%CI=3.16-4.34, P<0.01), hospital stay ≥ 15 d(OR=3.12, 95%CI=2.57-3.79, P<0.01), fetal age < 37 w(OR=2.56, 95%CI=2.11-3.11, P<0.01), age days<7 d(OR=2.56, 95%CI=2.10-3.13, P<0.01), birth weight < 2.5 kg(OR=1.89, 95%CI=1.54-2.33, P<0.01), antibiotics combination(OR=1.49, 95%CI=1.15-1.94, P=0.003) and non-breastfeeding(OR=0.69, 95%CI=0.53-0.90, P=0.007) were risk factors for AAD in Chinese neonates. CONCLUSION Current evidence shows that low gestational age, low birth weight, low birth age, antibiotic combination, invasive operation, long hospital stay, non-breastfeeding are risk factors for AAD in neonates.