Intrapartum beta-lactam antibiotics for preventing group B streptococcal early-onset disease: can we abandon the concept of "inadequate" intrapartum antibiotic prophylaxis?

Intrapartum beta-lactam antibiotics for preventing group B streptococcal early-onset disease: can we abandon the concept of "inadequate" intrapartum antibiotic prophylaxis? Expert Rev Anti Infect Ther. 2019 Nov 23;: Authors: Berardi A, Spada C, Vaccina E, Boncompagni A, Bedetti L, Lucaccioni L Abstract Introduction: Neonatal sepsis remains a serious and potentially fatal illness. Intrapartum antibiotic prophylaxis (IAP) prevents group B streptococcal (GBS) early-onset sepsis. The optimal duration of IAP (adequate IAP) to reduce vertical transmission of GBS has been debated. Understanding the mechanism of action of IAP may help in minimizing neonatal evaluation and unnecessary antibiotic use.Areas covered: In recent years, several studies on pharmacokinetics and clinical use of IAP have been published. Although penicillin and ampicillin are the most preferred antibiotics, the clinical efficacy of non-beta-lactam antibiotics, including clindamycin and vancomycin, used in cases of penicillin anaphylaxis-associated allergy, remains debatable. This is a narrative review of the literature regarding the impact of "inadequate" IAP on the clinical management of women and newborns.Expert opinion: Recent evidence suggests that "inadequate" IAP with beta-lactams is more effective in preventing vertical transmission of GBS than previously thought. Newborns exposed to intrapartum beta-lactams and who are asymptomatic at birth are likely uninfected...
Source: Expert Review of Anti-Infective Therapy - Category: Infectious Diseases Tags: Expert Rev Anti Infect Ther Source Type: research