Benzylpenicillin concentrations in umbilical cord blood and plasma of premature neonates following intrapartum doses for group B streptococcal prophylaxis.
Amadou Samb, Thomas H Dierikx, Yuma A Bijleveld, Timo R de Haan, Caspar J Hodiamont, Elisabeth van Leeuwen, Anton H L C van Kaam, Ron A A Mathôt, Douwe H Visser
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引用次数: 0
Abstract
Background and method: Dutch obstetrics guideline suggest an initial maternal benzylpenicillin dose of 2,000,000 IU followed by 1,000,000 IU every 4 h for group-B-streptococci (GBS) prophylaxis. The objective of this study was to evaluate whether concentrations of benzylpenicillin reached concentrations above the minimal inhibitory concentrations (MIC) in umbilical cord blood (UCB) and neonatal plasma following the Dutch guideline.
Results: Forty-six neonates were included. A total of 46 UCB samples and 18 neonatal plasma samples were available for analysis. Nineteen neonates had mothers that received intrapartum benzylpenicillin. Benzylpenicillin in UCB corresponded to concentrations in plasma drawn directly postpartum (R2 = 0.88, p < 0.01). A log-linear regression suggested that benzylpenicillin concentrations in neonates remained above the MIC threshold 0.125 mg/L up to 13.0 h after the last intrapartum dose.
Conclusions: Dutch intrapartum benzylpenicillin doses result in neonatal concentrations above the MIC of GBS.
背景和方法:荷兰产科指南建议孕妇初始剂量为2,000,000 IU,随后每4 h 1,000,000 IU用于b群链球菌(GBS)预防。本研究的目的是评估青霉素的浓度是否达到最低抑制浓度(MIC)以上的脐带血(UCB)和新生儿血浆遵循荷兰指南。结果:纳入46例新生儿。共有46份UCB样本和18份新生儿血浆样本可供分析。19名新生儿的母亲在分娩时接受了青霉素治疗。结论:荷兰产时给药导致新生儿青霉素浓度高于GBS的MIC。