Intrapartum Administration Of Antibiotics Research Articles

Prenatalni i perinatalni faktori rizika za razvoj alergijskih bolesti

For allergic diseases to develop, three components must be present: heredity, allergen contact and environmental factors. Allergic diseases are the most common chronic diseases in children and adolescents. This paper aims to present the latest findings on prenatal and perinatal risk factors for the development of atopic disease. The analysis was conducted by researching papers from the MEDLINE and PubMed databases published before September 2021. It has been determined that a mother's immune system during pregnancy plays a key role in the development of the fetus and affects the overall well-being of her offspring later in life. Immune dysregulation during the gestation period is proven to be associated with adverse maternal, fetal and neonatal outcomes. Contrary to the long-established belief that amniotic fluid is a sterile medium, it is now known that the fetus receives its first dose of probiotics by swallowing amniotic fluid. In connection with that, the microbiota of the mother greatly affects the microbiome of the newborn. Premature birth, cesarean delivery, intrapartum administration of antibiotics and other drugs can all harm the formation of the baby's microbiome. Understanding the importance of environmental factors in the pathogenesis of allergic diseases as well as the old hygiene hypothesis concept in the light of microbial disorders, it is clear that all previously mentioned parameters can have a very important impact on the development of allergic diseases in children.

Intrapartum antibiotics for prolonged rupture of membranes at term to prevent Group B Streptococcal sepsis

The timely administration of intrapartum antibiotic prophylaxis (IAP) to eligible pregnant mothers reduces the risk of early onset Group B Streptococcus (GBS) neonatal sepsis. The incidence of neonatal GBS sepsis is increasing, in spite of national guidelines for its prevention. This retrospective cohort study was undertaken to assess the incidence of culture-proven GBS sepsis before and after a change of practice on intrapartum management of GBS sepsis in babies born at Sunderland Royal Hospital between January 1 2008 and December 31 2017. The data regarding the risk factors, the intrapartum antibiotic prophylaxis and the outcomes of the babies were collected. Twenty-nine cases were identified and presented in two epochs—before and after changing guidelines for intrapartum management. There was a statistically significant reduction in early onset sepsis rates and no difference in late-onset sepsis rates. The prolonged rupture of membranes is a significant risk factor at any gestation. Impact statement What is already known on this subject? Appropriate intrapartum administration of antibiotics in mothers reduces 80% of early-onset GBS infections. In the United Kingdom, IAP is given based on risk factors, which fail to accurately identify and treat the woman who harbours GBS in the birth canal in labour and the incidence of GBS neonatal sepsis is increasing. The national guideline on the prevention of GBS sepsis is not consistent and is open to interpretation. What do the results of this study add? This study highlights prolonged rupture of membranes as a significant risk factor at any gestation and there were missed opportunities to prevent GBS sepsis in term babies with the prolonged rupture of membranes. This study also highlights that it is possible to reduce the neonatal GBS sepsis burden by adhering to guidelines and administering timely intrapartum antibiotics. What are the implications of these findings for clinical practice and/or further research? The timely administration of IAP to all eligible women is possible if the national guidelines are consistent and interpreted correctly. Our national guideline on the prolonged rupture of membranes at term is not clear and is interpreted differently. If IAP is provided in all those with risk factors irrespective of gestation, this would involve additional costs to the NHS; but in the long term, it will benefit as it reduces morbidity.

The Temporal Relation Between Intrapartum Penicillin Prophylaxis and Group B Streptococcus Counts

Intrapartum administration of antibiotics (penicillin or ampicillin) to mothers with positive cultures for group B streptococcus (GBS) reduces the risk

Antenatal prevention of neonatal group B streptococcal infection

Group B streptococci can be isolated from the vagina of 15–40% of pregnant women. Vertical transmission to the infant occurs in 50% of deliveries involving colonised women. Most infants remain asymptomatic, but 1–2% develop clinical infection, which is associated with significant morbidity and mortality. Vertical transmission can be successfully prevented by intrapartum administration of antibiotics. Other proposed methods include vaccines and intrapartum vaginal or neonatal washing with antiseptics. Selection of women for prophylactic antibiotics can be based on risk factors, screening or a combination of both. Benefits of prophylaxis should be balanced against cost, medicalisation of labour and the risks of anaphylaxis and bacterial resistance. We present an overview of vaginal group B streptococcal isolation methods and antenatal strategies for prevention of neonatal infection.