The association of intrapartum antibiotic exposure with the incidence and antibiotic resistance of infantile late-onset serious bacterial infections

Clin Pediatr (Phila). 2011 Sep;50(9):827-33. doi: 10.1177/0009922811406260.

Abstract

Background: The widespread use of intrapartum antibiotics (IPA) has raised concerns regarding the adverse effects on the newborn.

Objectives: To determine if IPA is associated with infantile late-onset serious bacterial infections (SBIs) and with antibiotic resistance.

Patients and methods: From 2005 to 2009, data were prospectively collected for all infants born at our center, aged 7 to 90 days, who were hospitalized for fever. Cases included infants with culture-proven SBIs, and controls included infants without SBIs. Results. A total of 71 cases and 124 controls were included. IPA was documented in 11.3% of cases and in 7.3% of controls (P = .34). Among cases, ampicillin resistance was documented in 85% of antibiotic-exposed infants and in 63% of nonexposed infants (P = .19). Corresponding rates for first-generation cephalosporin resistance in urinary tract infection were 75% and 23.5% (P = .04).

Conclusion: IPA is associated with a trend toward increased antibiotic resistance in late-onset SBIs. This should be taken into consideration in the selection of empirical therapy for febrile infants.

MeSH terms

  • Adult
  • Age of Onset
  • Anti-Bacterial Agents / adverse effects*
  • Bacteremia* / epidemiology
  • Bacteremia* / microbiology
  • Case-Control Studies
  • Drug Resistance, Bacterial*
  • Female
  • Fever / microbiology
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Microbial Sensitivity Tests
  • Pregnancy
  • Pregnancy Complications, Infectious / drug therapy*
  • Prenatal Exposure Delayed Effects* / epidemiology
  • Prospective Studies
  • Streptococcal Infections / epidemiology
  • Streptococcal Infections / microbiology
  • Streptococcus agalactiae / drug effects
  • Urinary Tract Infections* / epidemiology
  • Urinary Tract Infections* / microbiology

Substances

  • Anti-Bacterial Agents