International Digest

Limiting intrapartum antibiotic therapy in neonates

Canadian Medical Association Journal 1996; 155: 909

Source: Singhal KK, La Gamma EF. Management of 168 neonates weighing more than 2000 g receiving intrapartum chemoprophylaxis for chorioamnionitis. Evaluation of an early discharge strategy. Arch Pediatr Adolesc Med 1996; 150: 158-63.

Researchers in New York state evaluated the results of limiting antimicrobial therapy (ampicillin and gentamicin) in 168 neonates with birth weights of more than 2000 g whose mothers had been given antibiotic therapy intrapartum for presumed intra-amniotic infection. Screening included complete blood counts and differential counts, body fluid cultures and sequential physical examination. Antibiotics were discontinued on postnatal day 3 in asymptomatic infants with normal laboratory and clinical results and in those with a single laboratory or clinical abnormality. Infants with persistently abnormal complete blood counts, multiple clinical signs of sepsis or bacteria-positive body-fluid cultures were treated for 7 days or more. On the basis of screening results, 82% of neonates were given only 3 days of therapy, significantly reducing their length of hospital stay. No adverse outcomes or hospital readmissions were reported in any infants 1 month after discharge.

| CMAJ October 1, 1996 (vol 155, no 7) |