Potential consequences of widespread antepartal use of ampicillin☆,☆☆,★,★★
Section snippets
Material and methods
A prospective cohort study was performed from January 1, 1991, through December 31, 1996. Every case of blood culture–proven neonatal sepsis from the nursery at Long Beach Memorial Women’s Hospital was prospectively surveyed. Early-onset neonatal sepsis was defined as a positive blood culture result for a neonate with clinical symptoms at <7 days after birth. This study was reviewed and approved by the institution’s review board.
Maternal data collected included use of antenatal antibiotics,
Results
During the 6-year study period, 42 cases of documented, blood culture–proven early-onset neonatal sepsis occurred. Group B streptococci were the bacteria involved in 15 of the 42 cases; the remaining 27 cases were the result of non–group B streptococcal organisms. The basic bacterial category of the 27 non–group B streptococcal cases consisted of 21 gram-negative rods and 6 gram-positive cocci.
Among the 27 non–group B streptococcal cases, 15 mothers received antenatal ampicillin, and 13 of the
Comment
Although many different problems can develop from the use of antibiotics, 3 basic concerns are most often cited. These involve the development of resistance by the bacteria to a specific type of antibiotic, the selection of resistant organisms, and reactions, such as colitis, allergic reactions, and anaphylaxis, to the specific antibiotic employed.1, 2 In the use of antibiotics in the field of obstetrics, both the mother and the neonate may suffer consequences if the short course of antibiotic
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From University of California, Irvine,a Long Beach Memorial Women’s Hospital,b St Joseph’s Hospital,c the Department of Obstetrics and Gynecology, Medical College of Wisconsin,d Long Beach Memorial Miller Children’s Hospital.e
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Supported in part by the Memorial Medical Center Foundation, Long Beach, California. Research performed at Long Beach Memorial Women’s Hospital, Long Beach, California.
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Reprint requests: Craig V. Towers, MD, PO Box 8400, Huntington Beach, CA 92615-8400.
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