RT Journal Article
SR Electronic
T1 Timing and dosage of intrapartum prophylactic penicillin for preventing early-onset group B streptococcal disease: assessing maternal and umbilical cord blood concentration
JF Archives of Disease in Childhood - Fetal and Neonatal Edition
JO Arch Dis Child Fetal Neonatal Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP fetalneonatal-2024-326986
DO 10.1136/archdischild-2024-326986
A1 Nielsen, Stine Yde
A1 Hoffmann-Lücke, Elke
A1 Henriksen, Tine Brink
A1 Hartvigsen, Camilla Mirian
A1 Helmig, Rikke Bek
A1 Khalil, Mohammed Rohi
A1 Møller, Jens Kjølseth
A1 Pedersen, Lars Henning
A1 Murra, May
A1 Greibe, Eva
YR 2024
UL http://fn.bmj.com/content/early/2024/05/10/archdischild-2024-326986.abstract
AB Objective Timing of administration of antibiotics and concentrations in maternal blood and the umbilical cord blood are important prerequisites for optimal intrapartum antibiotic prophylaxis (IAP) of neonatal early-onset group B streptococcus (GBS) disease. This cohort study aimed to explore penicillin concentrations in mothers and infants at birth in relation to time elapsed from administration to delivery and to the minimal inhibitory concentration (MIC) for GBS.Main outcome measures Penicillin G concentrations in maternal and umbilical cord blood in relation to time and dose from administration to time of delivery.Results In 44 mother–infant dyads, median maternal penicillin G concentration was 0.2 mg/L (IQR 0–0.8 mg/L; range 0–1.6 mg/L). Median infant penicillin G concentration was 1.2 mg/L (IQR 0.5–5.0 mg/L; range 0–12.7 mg/L). In all infants (N=38) born less than 4 hours after the latest IAP administration, penicillin G concentrations far exceeded MIC (0.125 mg/L), even after short time intervals between IAP administration and birth. The highest plasma concentrations were reached in umbilical cord blood within 1 hour from IAP administration to birth.For 44 mother–infant dyads, maternal concentrations were very low compared with their infants’; particularly, very high concentrations were seen in the 20 infants with only one dose of IAP.Conclusion High concentrations of penicillin G were found in umbilical cord blood of infants born less than 4 hours after IAP administration, well above the MIC for GBS.Data are available upon reasonable request.