Intramuscular penicillin for the prevention of early onset group B streptococcal infection in newborn infants

Abstract

This review does not support the routine use of intramuscular penicillin to prevent EOGBSD in newborn infants. There is a discrepancy between this finding and the results of a number of larger non-randomised trials. Explanations for this are proposed. There is a need for this intervention to be tested as a component of the existing prevention strategies in widespread use.

Postnatal penicillin prophylaxis of early-onset group B streptococcal infection in term newborns. A preliminary study

“…However, a Cochrane review focused on a large randomized controlled trial 24 does not support the routine use of intramuscular penicillin to prevent EOGBSD in newborn infants 14 . In summary, the evidence from uncontrolled, retrospective and non-randomized controlled prospective studies supports the use of postnatal intramuscular penicillin in newborns to prevent EOGBSD 14,25,26,27 . We do accept that routine administration of antibiotics for all newborns born to mothers who received IAP to prevent GBS disease is not recommended 5,13 .…”

“…Women with prenatal GBS colonization are 25 times more likely than women with negative prenatal cultures to deliver infants with the disease 13 . The prevalence of recto-vaginal colonization among pregnant women ranges from 15 to 40 % 14 . The colonization is dynamic, and mostly asymptomatic.…”

“…The complete absence of EOGBSD was reported as an unexpected benefi t of a policy of routine administration of intramuscular penicillin to prevent gonococcal ophthalmia 17 . Giving an injection of penicillin immediately after birth to newborn babies routinely has been proposed as another way of preventing GBS infection 14 . Some centers administer intramuscular penicillin to asymptomatic infants within 1 hour after birth, based on results of observational studies showing declines in EOGBSD 13 .…”