Santiago Scasso1, Joel Laufer2, Grisel Rodriguez3, Justo G Alonso2, Claudio G Sosa4. 1. Department of Obstetrics and Gynecology, Pereira Rossell Hospital, University of Uruguay, Montevideo, Uruguay. Electronic address: sscasso@gmail.com. 2. Department of Obstetrics and Gynecology, Pereira Rossell Hospital, University of Uruguay, Montevideo, Uruguay. 3. Department of Microbiology, University of Uruguay, Montevideo, Uruguay. 4. Department of Obstetrics and Gynecology, Pereira Rossell Hospital, University of Uruguay, Montevideo, Uruguay; Department of Epidemiology, University of Uruguay, Montevideo, Uruguay.
Abstract
OBJECTIVE: To assess maternal group B streptococcus (GBS) colonization status and the pharmacokinetic profile of penicillin G in the umbilical cord and amniotic fluid compartment during 4 hours of intrapartum antibiotic prophylaxis (IAP). METHODS: In a prospective study at a hospital in Montevideo, Uruguay, 60 GBS carriers in active labor after a singleton pregnancy of 37 weeks or more were enrolled between April 1, 2011, and April 30, 2012. Intravenous penicillin G was administered via a standard regimen. Rectovaginal samples were obtained before IAP initiation, and 2 and 4 hours after the initial dose. Penicillin G concentrations were measured by high-performance liquid chromatography. Samples were obtained from fetal cord blood in all cases and from amniotic fluid obtained from patients who delivered by cesarean. RESULTS: Among the 60 participants, 43 (72%) had a positive rectovaginal sample before IAP initiation. Of these women, 23 (53%) had negative cultures after 2 hours; after 4 hours, only 5 (12%) remained positive for GBS. The penicillin G concentration in amniotic fluid and cord blood was above the minimum inhibitory concentration (0.12 μg/mL) in all cases. CONCLUSION: Four hours of IAP was needed to reduce the number of women with positive GBS cultures to 12%. Therefore, 4 hours of IAP might be necessary to achieve overall effectiveness from this treatment.
OBJECTIVE: To assess maternal group B streptococcus (GBS) colonization status and the pharmacokinetic profile of penicillin G in the umbilical cord and amniotic fluid compartment during 4 hours of intrapartum antibiotic prophylaxis (IAP). METHODS: In a prospective study at a hospital in Montevideo, Uruguay, 60 GBS carriers in active labor after a singleton pregnancy of 37 weeks or more were enrolled between April 1, 2011, and April 30, 2012. Intravenous penicillin G was administered via a standard regimen. Rectovaginal samples were obtained before IAP initiation, and 2 and 4 hours after the initial dose. Penicillin G concentrations were measured by high-performance liquid chromatography. Samples were obtained from fetal cord blood in all cases and from amniotic fluid obtained from patients who delivered by cesarean. RESULTS: Among the 60 participants, 43 (72%) had a positive rectovaginal sample before IAP initiation. Of these women, 23 (53%) had negative cultures after 2 hours; after 4 hours, only 5 (12%) remained positive for GBS. The penicillin G concentration in amniotic fluid and cord blood was above the minimum inhibitory concentration (0.12 μg/mL) in all cases. CONCLUSION: Four hours of IAP was needed to reduce the number of women with positive GBS cultures to 12%. Therefore, 4 hours of IAP might be necessary to achieve overall effectiveness from this treatment.
Authors: Rebecca E Moore; Harrison C Thomas; Shannon D Manning; Jennifer A Gaddy; Steven D Townsend Journal: Chembiochem Date: 2021-11-29 Impact factor: 3.461
Authors: María Dolores López-Medina; Ana Belén López-Araque; Manuel Linares-Abad; Isabel María López-Medina Journal: PLoS One Date: 2020-01-10 Impact factor: 3.240