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Intrapartum antibiotic prophylaxis 1: relative effects of recommended antibiotics on gram-negative pathogens

Rodney K Edwards1, Penny Clark, Christopher L Sistrom

  • 1Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Florida College of Medicine, Gainesville 32610-0294, USA. edwardsr@obgyn.ufl.edu

Obstetrics and Gynecology
|September 11, 2002
PubMed

Insights

Intrapartum antibiotic prophylaxis with ampicillin or penicillin increases neonatal exposure to ampicillin-resistant bacteria. This study found no significant difference between the two antibiotics in this regard.

Area of Science:

  • Obstetrics and Gynecology
  • Neonatal Medicine
  • Infectious Diseases

Background:

  • Intrapartum antibiotic prophylaxis is crucial for preventing neonatal infections.
  • The choice of antibiotic may influence the development of antimicrobial resistance in neonates.

Purpose of the Study:

  • To determine if ampicillin or penicillin, used for intrapartum antibiotic prophylaxis, impacts neonatal exposure to ampicillin-resistant gram-negative bacteria.
  • To compare the rates of ampicillin-resistant Enterobacteriaceae in neonates exposed to ampicillin versus penicillin prophylaxis.

Main Methods:

  • A randomized clinical trial comparing ampicillin and penicillin for intrapartum antibiotic prophylaxis.
  • Collection of genital tract cultures from mothers at entry and postpartum.
  • Isolation, identification, and susceptibility testing of Enterobacteriaceae for ampicillin resistance.

Main Results:

  • No significant difference in ampicillin-resistant Escherichia coli or Enterobacteriaceae rates between ampicillin and penicillin groups at entry or postpartum.
  • A significant increase in postpartum rates of ampicillin-resistant E. coli and Enterobacteriaceae compared to entry rates in both antibiotic groups.
  • These findings held true even when considering women receiving multiple doses or no additional antibiotics.

Conclusions:

  • Intrapartum antibiotic prophylaxis, regardless of whether ampicillin or penicillin is used, leads to increased neonatal exposure to ampicillin-resistant Enterobacteriaceae.
  • The study highlights a potential unintended consequence of intrapartum antibiotic use on neonatal microbiome resistance patterns.
Abstract

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