Role of antibiotics in meconium aspiration syndrome.
BACKGROUND
Meconium aspiration syndrome (MAS) is a major cause of severe respiratory distress in newborns and the role of antibiotics in its management is not well defined.


OBJECTIVE
To determine the role of routine antibiotic therapy in the management of MAS.


METHODS
After excluding the possibility of sepsis, 144 patients with MAS were randomised into two groups. Group A (study group) received ampicillin and gentamicin for 7 days, commencing between 24 and 36 hours of life, and group B, the controls, received no antibiotics. Both groups received similar supportive management. The primary outcome measure was the development of infection. Details of clinical progress during hospitalisation were recorded. All were followed up for a minimum of 3 months.


RESULTS
The patient profiles were similar in both groups. Five patients (three in the study group, two controls) developed culture-positive sepsis during their hospital stay. No significant difference was detected between the groups regarding period of oxygen dependency (5.8 vs 5.9 days), day of starting feeds (4.0 vs 4.2), day of achievement of full feeds (9.4 vs 9.3), clearance of chest radiograph (11.7 vs 12.9 days) or duration of hospital stay (13.7 vs 13.5 days). The most common radiological features were parenchymal infiltrates followed by hyperinflation. The incidence of complications was similar in both groups.


CONCLUSIONS
Routine antibiotic therapy is not necessary for managing MAS.
Basu
Sriparna
S
Division of Neonatology, Department of Paediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India. drsriparnabasu@rediffmail.com
Kumar
Ashok
A
Bhatia
B D
BD
D000667:Ampicillin / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D001724:Birth Weight; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005839:Gentamicins / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D008471:Meconium Aspiration Syndrome / Q000188:drug therapy*; D009894:Opportunistic Infections / Q000209:etiology / Q000517:prevention & control*; D019564:Unnecessary Procedures
D000900:Anti-Bacterial Agents; D005839:Gentamicins; D000667:Ampicillin