Pattern of Inflammatory Markers and Use of Antibiotics in Meconium Aspiration Syndrome: A Retrospective Cohort Study.

Abstract

Objectives To study the pattern of inflammatory markers in meconium aspiration syndrome (MAS) and their correlation with illness severity/antibiotic usage. Study design This is a retrospective analysis of neonates who were admitted with MAS and had inflammatory markers done during the first week of life. Results Seventy-six neonates with MAS were identified. White cell count (WCC), absolute neutrophil count (ANC), and immature to total neutrophil count (I/T) ratiopeaked at 12 and CRP (43.75 mg/dl) at 48 hours of life (HOL). Neonates needing nasal cannula oxygen had lower CRP at 12 (p=0.035) and 24 HOL (p=0.046). There was no correlation between CRP at 48 HOL and score for neonatal acute physiology and perinatal extension II (SNAPPE-II; R2 0.0004). High CRP at 24 HOL was associated with longer duration of antibiotics (p<0.001) despite no correlation with the blood cultures. Conclusion MAS was associated with inflammatory markers peaking at 12 to 48 HOL; however, antibiotics should not be determined based on them as their correlation for illness severity or blood culture is poor.