title: Duration of intrapartum antibiotics for group B streptococcus on the diagnosis of clinical neonatal sepsis.
abstract: BACKGROUND
  Infants born to mothers who are colonized with group B streptococcus (GBS) but received <4 hours of intrapartum antibiotic prophylaxis (IAP) are at-risk for presenting later with sepsis. We assessed if <4 hours of maternal IAP for GBS are associated with an increased incidence of clinical neonatal sepsis.
  
  
  METHODS
  A retrospective cohort study of women-infant dyads undergoing IAP for GBS at ≥37-week gestation who presented in labor from January 1, 2003 through December 31, 2007 was performed. Infants diagnosed with clinical sepsis by the duration of maternal IAP received (< or ≥4-hours duration) were determined.
  
  
  RESULTS
  More infants whose mothers received <4 hours of IAP were diagnosed with clinical sepsis, 13 of 1,149 (1.1%) versus 15 of 3,633 (0.4%), P = .03. Multivariate logistic regression analysis showed that treatment with ≥4 hours of IAP reduced the risk of infants being diagnosed with clinical sepsis by 65%, adjusted relative risk 0.35, CI 0.16-0.79, and P = .01.
  
  
  CONCLUSIONS
  The rate of neonatal clinical sepsis is increased in newborns of GBS colonized mothers who receive <4 hours compared to ≥4 hours of IAP.
authors.affiliation: Department of Obstetrics & Gynecology, Kelsey-Seybold West Clinic, 1111 Augusta Drive, Houston, TX 77057, USA. mark.turrentine@kelsey-seybold.com
authors.forename: Mark A
authors.initials: MA
authors.lastname: Turrentine
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Greisinger
authors.forename: Kimberly S
authors.initials: KS
authors.lastname: Brown
authors.forename: Oscar A
authors.initials: OA
authors.lastname: Wehmanen
authors.forename: Melanie E
authors.initials: ME
authors.lastname: Mouzoon
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D002353:Carrier State / Q000188:drug therapy; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008297:Male; D015999:Multivariate Analysis; D011247:Pregnancy; D012189:Retrospective Studies; D018805:Sepsis / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D013290:Streptococcal Infections / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission*; D013292:Streptococcus agalactiae; D013781:Texas / Q000453:epidemiology; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents