PT  - JOURNAL ARTICLE
AU  - Zimmermann, Petra
AU  - Curtis, Nigel
TI  - Effect of intrapartum antibiotics on the intestinal microbiota of infants: a systematic review
AID  - 10.1136/archdischild-2018-316659
DP  - 2020 Mar 01
TA  - Archives of Disease in Childhood - Fetal and Neonatal Edition
PG  - 201--208
VI  - 105
IP  - 2
4099  - http://fn.bmj.com/content/105/2/201.short
4100  - http://fn.bmj.com/content/105/2/201.full
SO  - Arch Dis Child Fetal Neonatal Ed2020 Mar 01; 105
AB  - Introduction The use of intrapartum antibiotic prophylaxis (IAP) has become common practice in obstetric medicine and is used in up to 40% of deliveries. Despite its benefits, the risks associated with exposing large numbers of infants to antibiotics, especially long-term effects on health through changes in the microbiota, remain unclear. This systematic review summarises studies that have investigated the effect of IAP on the intestinal microbiota of infants.Methods A systematic search in Ovid MEDLINE was used to identify original studies that investigated the effect of IAP on the intestinal microbiota in infants. Studies were excluded if: they included preterm infants, the antibiotic regimen was not specified, antibiotics were used for indications other than prophylaxis, probiotics were given to mothers or infants, or antibiotics were given to infants.Results We identified six studies, which investigated a total of 272 infants and included 502 stool samples collected up to 3 months of age. In all the studies, IAP was given for group B streptococcus (GBS) colonisation. Infants who were exposed to GBS IAP had a lower bacterial diversity, a lower relative abundance of Actinobacteria, especially Bifidobacteriaceae, and a larger relative abundance of Proteobacteria in their intestinal microbiota compared with non-exposed infants. Conflicting results were reported for the phyla Bacteroidetes and Firmicutes.Conclusions GBS IAP has profound effects on the intestinal microbiota of infants by diminishing beneficial commensals. Such changes during the early-life ‘critical window’ during which the intestinal microbiota and the immune response develop concurrently may have an important influence on immune development. The potential long-term adverse consequences of this on the health of children warrant further investigation.