Within a randomized prospective pilot study of preterm infants born less than 33 weeks gestation, fecal samples were collected weekly and metabolomic analysis was performed. The objective is to evaluate for differences in fecal metabolites in infants exposed to antibiotics vs not exposed to antibiotics in the first 48hours after birth. Significant differences were seen in the antibiotics vs no antibiotics group, including pathways related to vitamin biosynthesis, bile acids, amino acid metabolism and neurotransmitters. Early antibiotic exposure in preterm infants may alter metabolites in the intestinal tract of preterm infants. Broader multi-omic studies that address mechanisms will guide more prudent antibiotic use in this population.
### Competing Interest Statement
Dr. Josef Neu is the principal investigator of a study with Infant Bacterial Therapeutics and on the Scientific Advisory Boards of Medela and Astarte. No other authors have conflicts of interest to disclose.