title: Does prenatal antibiotic therapy compromise the diagnosis of early-onset infection and management of the neonate?
abstract: To assess the impact of prenatal antibiotic treatment on procalcitonin (PCT) and C-reactive protein (CRP) concentrations in cord blood, and on the rate of positive neonatal blood cultures.
  
  
  
  Neonates with early-onset infection (Group A; n=46) were compared with healthy controls (Group B; n=240). We evaluated the relationship between prenatal antibiotic therapy and early-onset infection, and for interactions with antibiotic therapy in the neonate immediately after birth.
  
  
  
  In the Group A antibiotics were administered significantly more often prenatally and more often to neonates just after birth. The percentage of negative blood cultures in infected neonates was higher when antibiotic treatment was instituted prenatally. Differences in cord blood PCT and CRP concentrations were significant between both groups and were independent of prenatal antibiotic treatment. Streptococcus agalactiae was the most frequent species.
  
  
  
  Almost one-third of neonates present with early-onset infection in spite of prenatal antibiotic therapy. Cord blood PCT and CRP measurements may be helpful in the diagnosis of infection also in cases when antibiotic therapy was started prenatally. Prenatal antibiotic administration reduced the number of positive blood cultures in neonates with early-onset infection and was associated with a greater rate of antibiotic treatment after birth in neonates without infection.
authors.affiliation: Department of Neonatal Diseases, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Kordek
authors.forename: Andrzej
authors.initials: A
authors.lastname: Torbé
authors.forename: Wojciech
authors.initials: W
authors.lastname: Podraza
authors.forename: Beata
authors.initials: B
authors.lastname: Łoniewska
authors.forename: Joanna
authors.initials: J
authors.lastname: Jursa-Kulesza
authors.forename: Jacek
authors.initials: J
authors.lastname: Rudnicki
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D016470:Bacteremia / Q000175:diagnosis; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D005312:Fetal Blood / Q000737:chemistry / Q000382:microbiology; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis* / Q000188:drug therapy; D007239:Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy; D011295:Prenatal Care / Q000379:methods*; D011498:Protein Precursors / Q000097:blood; D013292:Streptococcus agalactiae / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide