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 K. A. Agyeman, Riccardo Pfister, Giuseppe Latorre, Gianfranco Maffei, Nichola Laforgia, Enikő Mózes, Ketil Størdal, Tobias Strunk and Eric Giannoni
Additional contact information
Martin Stocker: Children’s Hospital Lucerne
Claus Klingenberg: UiT-The Arctic University of Norway
Lars Navér: Karolinska University Hospital
Viveka Nordberg: Karolinska University Hospital
Alberto Berardi: Policlinico University Hospital
Salhab el Helou: McMaster University, Hamilton Health Sciences
Gerhard Fusch: McMaster University, Hamilton Health Sciences
Joseph M. Bliss: Warren Alpert Medical School of Brown University
Dirk Lehnick: University of Lucerne
Varvara Dimopoulou: Lausanne University Hospital and University of Lausanne
Nicholas Guerina: Warren Alpert Medical School of Brown University
Joanna Seliga-Siwecka: Medical University of Warsaw
Pierre Maton: Clinique CHC-Montlegia, groupe santé CHC
Donatienne Lagae: CHIREC-Delta Hospital
Judit Mari: University of Szeged
Jan Janota: Motol University Hospital Prague
Philipp K. A. Agyeman: Bern University Hospital, University of Bern
Riccardo Pfister: Geneva University Hospitals and Geneva University
Giuseppe Latorre: Ecclesiastical General Hospital F. Miulli
Gianfranco Maffei: Policlinico Riuniti Foggia
Nichola Laforgia: University of Bari
Enikő Mózes: Semmelweis University
Ketil Størdal: University of Oslo and Oslo University Hospital
Tobias Strunk: King Edward Memorial Hospital
Eric Giannoni: Lausanne University Hospital and University of Lausanne

Nature Communications, 2023, vol. 14, issue 1, 1-9

Abstract: 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.

Date: 2023
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DOI: 10.1038/s41467-023-38156-7

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