Intrapartum prophylaxis with ceftriaxone decreases rates of bacterial colonization and early-onset infection in newborns

Xavier Sáez-Llorens, Maria Sabina Ah-Chu, Elizabeth Castaño, Lourdes Cortés, Antonio Torres, Marixcel Suárez, Alberto Bissot, Winston Reyes, Warren B. Karp, George H. McCracken

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Because of high rates of neonatal gram-negative sepsis in many Latin American countries, we prospectively enrolled 784 high-risk pregnant women in a study designed to evaluate the effect of a single 1-g dose of ceftriaxone (n = 390) vs. that of no antibiotic prophylaxis (n = 394) on oral, rectal, and umbilical colonization and fatality rates among newborn infants. The mean ceftriaxone concentration in cord blood samples was 26 μg/ml, (range, 9-40 μg/mL). Compared with infants of untreated mothers, children born to women who were given ceftriaxone were colonized at a lesser rate by gram-negative bacilli (54% vs. 35%; P < .001) and by group B streptococci (54% vs. 21%; P = .03) and endured significantly fewer sepsis-like illnesses in the first 5 days of life (8.1% vs. 3.1%; P = .004). There was also a tendency for them to have fewer episodes of culture-proven early-onset sepsis (2.8% vs. 0.5%; P = .06). Sepsis-related case-fatality rates (0.8% and 0.3%, respectively) were not significantly different. Although intrapartum administration of a single dose of ceftriaxone to high-risk mothers could be a safe and potentially useful strategy for reducing early-onset neonatal infections, additional information is required before this approach can be recommended for routine prophylaxis.

Original languageEnglish (US)
Pages (from-to)876-880
Number of pages5
JournalClinical Infectious Diseases
Volume21
Issue number4
StatePublished - Oct 1995

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Ceftriaxone
Sepsis
Newborn Infant
Infection
Mothers
Umbilicus
Streptococcus agalactiae
Antibiotic Prophylaxis
Fetal Blood
Bacillus
Pregnant Women
Mortality

ASJC Scopus subject areas

  • Immunology

Cite this

Intrapartum prophylaxis with ceftriaxone decreases rates of bacterial colonization and early-onset infection in newborns. / Sáez-Llorens, Xavier; Ah-Chu, Maria Sabina; Castaño, Elizabeth; Cortés, Lourdes; Torres, Antonio; Suárez, Marixcel; Bissot, Alberto; Reyes, Winston; Karp, Warren B.; McCracken, George H.

In: Clinical Infectious Diseases, Vol. 21, No. 4, 10.1995, p. 876-880.

Research output: Contribution to journalArticle

Sáez-Llorens, X, Ah-Chu, MS, Castaño, E, Cortés, L, Torres, A, Suárez, M, Bissot, A, Reyes, W, Karp, WB & McCracken, GH 1995, 'Intrapartum prophylaxis with ceftriaxone decreases rates of bacterial colonization and early-onset infection in newborns', Clinical Infectious Diseases, vol. 21, no. 4, pp. 876-880.
Sáez-Llorens X, Ah-Chu MS, Castaño E, Cortés L, Torres A, Suárez M et al. Intrapartum prophylaxis with ceftriaxone decreases rates of bacterial colonization and early-onset infection in newborns. Clinical Infectious Diseases. 1995 Oct;21(4):876-880.
Sáez-Llorens, Xavier ; Ah-Chu, Maria Sabina ; Castaño, Elizabeth ; Cortés, Lourdes ; Torres, Antonio ; Suárez, Marixcel ; Bissot, Alberto ; Reyes, Winston ; Karp, Warren B. ; McCracken, George H. / Intrapartum prophylaxis with ceftriaxone decreases rates of bacterial colonization and early-onset infection in newborns. In: Clinical Infectious Diseases. 1995 ; Vol. 21, No. 4. pp. 876-880.
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