Abstract
ObjectiveTo assess maternal group B streptococcus (GBS) colonization status and the pharmacokinetic profile of penicillin G in the umbilical cord and amniotic fluid compartment during 4hours of intrapartum antibiotic prophylaxis (IAP). MethodsIn a prospective study at a hospital in Montevideo, Uruguay, 60 GBS carriers in active labor after a singleton pregnancy of 37weeks 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 4hours 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. ResultsAmong the 60 participants, 43 (72%) had a positive rectovaginal sample before IAP initiation. Of these women, 23 (53%) had negative cultures after 2hours; after 4hours, only 5 (12%) remained positive for GBS. The penicillin G concentration in amniotic fluid and cord blood was above the minimum inhibitory concentration (0.12μg/mL) in all cases. ConclusionFour hours of IAP was needed to reduce the number of women with positive GBS cultures to 12%. Therefore, 4hours of IAP might be necessary to achieve overall effectiveness from this treatment.
Published Version
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