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[Therapy of neonatal infection caused by group B beta-hemolytic Streptococcus]
A Aabas1, M Berzioli, P Brisotto
1Divisione di Pediatria dell'Ospedale, Asiago (VI), Italia.
Insights
Early treatment for Group B Streptococcus septicemia requires broad-spectrum antibiotics like ampicillin and netilmicin to cover other potential pathogens. Supportive care is crucial for managing symptoms and improving outcomes in neonates.
Area of Science:
- Neonatal infectious diseases
- Microbiology
- Pharmacology
Context:
- Group B Streptococcus (GBS) is a leading cause of neonatal sepsis.
- Early-onset GBS sepsis requires prompt and effective antimicrobial treatment.
- Co-infection with other pathogens is a significant concern.
Purpose:
- To outline the principles of expectant therapy for early-onset GBS septicemia.
- To identify key antimicrobial agents and supportive care measures.
- To discuss the role of adjunctive therapies.
Summary:
- Initial expectant therapy for GBS sepsis involves broad-spectrum antibiotics such as ampicillin and an aminoglycoside (e.g., netilmicin) to cover likely pathogens including L. Monocytogenes, H. Influenzae, and S. Pneumoniae.
- Alternative agents like vancomycin, teicoplanin, and cefotaxime may be used.
- Supportive care includes temperature regulation, fluid management, electrolyte monitoring, seizure control, and ventilation.
Impact:
- Ensuring comprehensive coverage against potential pathogens improves treatment efficacy.
- Aggressive supportive care is vital for managing severe neonatal sepsis.
- The use of immunoglobulins and G-CSF may offer additional benefits in severe cases.
Abstract:
Expectant therapy for early Group B Streptococcus onset septicemia must provide coverage against other microorganism, such as L. Monocytogenes, H. Influenzae and S. Pneumoniae. It is possible to administer a combination of antimicrobial agents with activity against all or the most likely pathogens. Thus initial expectant therapy includes a broad spectrum semisynthetic penicillin (e.g. ampicillin) and an aminoglycoside (e.g. netilmicin). Vancomicin, teicoplanin and cefotaxime may also be used. Supportive therapy consists on temperature control, i.v. administration of fluids, acid-base balance and electrolytes monitoring, seizures control and ventilation. IV immunoglobulins, granulocyte and serum transfusion are also used. The G-Colony Stimulating Factor (G-CSF, filgastrim) usage is also reported.