Related Experiment Videos
Postnatal penicillin prophylaxis and the incidence of group B streptococcal sepsis in neonates
D M Patel1, M H Leblanc, J C Morrison
1Department of Pediatrics, University of Mississippi Medical School, Jackson 39216-4505.
Insights
Penicillin prophylaxis for newborns significantly reduced the incidence of group B streptococci (GBS) sepsis and positive blood cultures. However, this benefit was not observed in infants weighing 2,500 grams or less at birth.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Pediatrics
Background:
- Group B streptococci (GBS) is a leading cause of neonatal sepsis.
- Penicillin prophylaxis is a common strategy to prevent early-onset GBS disease.
Purpose of the Study:
- To evaluate the impact of penicillin prophylaxis on GBS sepsis incidence in neonates.
- To assess the effectiveness of penicillin prophylaxis across different infant weight groups.
Main Methods:
- Retrospective chart review of infants over a 3-year period.
- Comparison of GBS sepsis rates during periods with and without routine penicillin prophylaxis.
- Analysis of outcomes stratified by birth weight.
Main Results:
- Infants receiving penicillin prophylaxis showed a decreased incidence of clinical sepsis and GBS bacteremia.
- No significant difference in GBS sepsis or positive blood cultures was observed in infants weighing <= 2,500g.
- Fewer positive blood cultures were noted in septic infants who received penicillin.
Conclusions:
- Penicillin prophylaxis was associated with reduced GBS sepsis and bacteremia in neonates.
- The protective effect of penicillin prophylaxis was not evident in low-birth-weight infants (< or = 2,500g).
- Mortality from GBS sepsis remained unchanged across all weight groups during the study periods.
Abstract:
We conducted a retrospective chart review of infants, born over a 3-year period, who had positive urine latex agglutination and/or positive blood culture for group B streptococci (GBS). Infants routinely received intramuscular aqueous penicillin for the first half of the study period, and no penicillin was given for the subsequent 18 months. Overall, infants who received penicillin prophylaxis had a decreased incidence of clinical sepsis and positive blood culture for GBS (4.8/1,000 versus 8/1,000 and 1.3/1,000 versus 5.4/1,000, respectively). The incidence of GBS sepsis during the time of penicillin prophylaxis was not different from that in previously reported studies. When analyzed by weight groups, no difference in clinical sepsis or positive blood cultures for GBS was seen in the subset of infants weighing < or = 2,500 g at birth. There were fewer positive blood cultures in the infants who received penicillin and met the criteria for clinical sepsis. Mortality from GBS sepsis was unchanged during these two study periods in all weight groups.