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Prophylaxis of Early-onset Streptococcal Sepsis in Newborn Infants


Authors: L. Štillová 1;  K. Maťašová 1;  J. Štilla 2;  M. Zibolen 1
Authors‘ workplace: Neonatologická klinika JLF UK a UNM, Martin prednosta prof. MUDr. M. Zibolen, CSc. 1;  Klinika stomatológie a maxilofaciálnej chirurgie JLF UK a UNM, Martin prednostka doc. MUDr. D. Statelová, PhD. 2
Published in: Čes-slov Pediat 2010; 65 (10): 565-570.
Category: Original Papers

Overview

Objective:
To determine whether administration of penicillin at birth to a strictly defined group of term newborns is an effective and safe method to prevent early-onset group B streptococcal disease.

Methods:
A protocol for management of asymptomatic full-term infants born to GBS (Group B Streptococcus) colonized mothers was created. Either an abnormality of blood count or presence of more than one obstetric risk factor was chosen as the indication criteria for administering postnatal antibiotic prophylaxis (PAP).

Results:
The study sample consists of 669 newborns (12.9% of all term infants). PAP was administered in 126 cases. Indication criteria included leucocytosis in 116 cases, leucopenia in 4 case and obstetric risk factors in 6 cases. There were 2 cases of clinically manifest infection, but no case of sepsis was proven.

Conclusion:
Early-onset group B Streptococcus disease is a serious but preventable neonatal infection. Maternal intrapartum antibiotic prophylaxis does not prevent all cases of the disease. Management of asymptomatic neonates of GBS colonized mothers is problematic. The authors suggest that the strategy of selective PAP using penicillin may be an effective and safe method in order to reduce morbidity and mortality from streptococcal infections. Postnatal prophylaxis in a strictly defined group of newborn infants at risk for early-onset sepsis, may be effectively combined with intrapartum chemoprophylaxis.

Key words:
neonatal sepsis, early-onset infection, Streptococcus agalactiae, Group B Streptococcus (GBS), penicillin prophylaxis


Sources

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