Intrapartum Antibiotic Prophylaxis: Making an Evidence-Based Selection: In Reply

Abstract

ARTICLE In Reply .— We appreciate the interest of Drs Edwards and Duff in our article. We reported that previously healthy term infants younger than 90 days who were hospitalized because of serious bacterial infections (SBIs) were more likely to have been exposed to intrapartum antibiotics (IPAs) than were age-matched healthy controls. We also found that the causative organisms in infants with an SBI were more likely to be ampicillin-resistant if the infant's mother had been exposed to an IPA, which in our cases was mostly ampicillin.1 We argue that these findings support ascertaining a history of IPA exposure in young infants who are suspected of having an SBI and for recommending that, consistent with national guidelines, penicillin be used as an IPA rather than ampicillin. Edwards and Duff apparently believe that the American College of Obstetricians and Gynecologists, American Academy of Pediatrics, and Centers for Disease Control and Prevention recommendations for penicillin over ampicillin as an IPA …