Six day antimicrobial therapy for early-onset group B streptococcal infection in near-term and term neonates.
Antibiotics for the treatment of group B streptococcal (GBS) infection are usually given for 7-10 d. The aim of this prospective investigation was to study whether antibiotic treatment for 6 d is sufficient to treat early-onset GBS infection in term and near-term neonates. During a 2 y period 67 neonates of GBS-positive mothers developed GBS infection and were admitted to the neonatal intensive care unit. All neonates showed clinical signs of infection, C-reactive protein levels > 20 mg/l and/or elevated immature to total neutrophil ratio > 0.25. Two groups were differentiated: 10 neonates with proven sepsis with GBS-positive blood cultures (15%) and 57 neonates with presumed GBS infection with negative blood cultures but with GBS-positive surface swab cultures of ear (68%), nasopharyngeal (21%) or gastric aspirate (16%). All patients were GBS positive in 1 or more cultures. Antimicrobial therapy with ampicillin and cefotaxime was discontinued after 6 d. At that time all neonates were asymptomatic and laboratory results were normal. No relapse or death within 4 weeks after therapy was detected. In conclusion, antibiotic therapy for 6 d was sufficient to treat 10 neonates with proven and 57 neonates with presumed early-onset GBS infection. Owing to the small sample size, further studies are needed to show significant differences to longer therapy regimens.
Pöschl
Johannes M B
JM
Department of Pediatrics, Division of Neonatology, University of Heidelberg, Heidelberg, Germany. johannes_poeschl@med.uni-heidelberg.de
Hellstern
Gerald
G
Dertlioglou
Nermin
N
Ruef
Peter
P
Meyburg
Jochen
J
Beedgen
Bernd
B
Linderkamp
Otwin
O
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D016470:Bacteremia / Q000517:prevention & control*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D011237:Predictive Value of Tests; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis; D011446:Prospective Studies; D018570:Risk Assessment; D013290:Streptococcal Infections / Q000188:drug therapy* / Q000635:transmission; D013292:Streptococcus agalactiae / Q000302:isolation & purification*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents