title: [Maternal antibiotic use and Gram negative bacteria infection in neonates].
abstract: Prevention strategies by maternal antibiotic use have provided undeniable benefits for neonates regarding early neonatal group B streptococcal infections. But at a time where the evolution of resistance of Gram negative bacteria is of particular concern, it is our duty to reassess prevention strategies with a careful evaluation of their potential impact on Gram negative bacteria in the newborn. We conducted a literature review to define the state of the art of antenatal antibiotic prophylaxis and its bacteriological consequences on the newborn. Prevention strategies of early-onset neonatal group B streptococcal disease with selective intrapartum chemoprophylaxis should not be challenged, even at the cost of a small increase of the incidence of late-onset infections with resistant Gram negative bacteria. However, other indications seem more controversial and the type of antibiotics used is not always based on methodologically well-conducted studies. In these indications the prevention strategies should consider not only the immediate expected benefits, but also the long-term ecological impact by using whenever possible narrow-spectrum antibiotics.
authors.affiliation: Service de Pédiatrie, Centre hospitalier de Versailles, 177, rue de Versailles, 78150 Le Chesnay, France. vhentgen@ch-versailles.fr
authors.forename: V
authors.initials: V
authors.lastname: Hentgen
authors.forename: R
authors.initials: R
authors.lastname: Cohen
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000517:prevention & control*; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D013290:Streptococcal Infections / Q000517:prevention & control; D013292:Streptococcus agalactiae
chemical_list: D000900:Anti-Bacterial Agents