Effects of Intrapartum Antibiotic Prophylaxis on Neonatal Sepsis
Author Information
Author(s): Rodney K. Edwards, Whitney E. Jamie, Donald Sterner, Susan Gentry, Kathy Counts, Patrick Duff
Primary Institution: University of Florida College of Medicine
Hypothesis
Does the type of intrapartum antibiotic prophylaxis affect the patterns of early-onset neonatal sepsis?
Conclusion
Coagulase-negative staphylococci have become the most common cause of early-onset neonatal sepsis, and this shift is not clearly related to intrapartum antibiotic exposure.
Supporting Evidence
- 75 cases of neonatal sepsis were identified during the study period.
- Coagulase-negative staphylococci became the most common cause of early-onset sepsis.
- 32% of isolates were resistant to ampicillin during the risk-based era compared to 61% during the screening-based era.
- 75% of infants infected with coagulase-negative staphylococci were not exposed to -lactam antibiotics within 72 hours prior to delivery.
- Statistical significance was found in the increase of ampicillin-resistant isolates (p = 0.014).
- Trends indicated a higher mortality rate during the screening-based era, but it did not reach statistical significance (p = 0.13).
Takeaway
This study looked at how different antibiotics given to mothers during labor affect infections in newborns. It found that a certain type of bacteria is now the most common cause of infections in babies, and this change isn't just because of the antibiotics given.
Methodology
Historical cohort study of infants born at a center from September 1993 to February 2000, comparing risk-based and screening-based antibiotic strategies.
Potential Biases
Potential bias due to the exclusion of infants born elsewhere and the reliance on medical records for data collection.
Limitations
The study is limited by its retrospective design and the potential for unmeasured confounding factors.
Participant Demographics
Infants born at Shands Hospital at the University of Florida, with a majority being preterm.
Statistical Information
P-Value
0.014
Statistical Significance
p<0.05
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