NeoNotes Journal Club
Andrew B. Kairalla MD, Editor
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ü
Designates reiteration of
1996 CDC guidelines.
Ø If a woman receives intrapartum antibiotics for treatment of suspected chorioamnionitis, her newborn should have a full diagnostic evaluation and empiric therapy (e.g. ampicillin and gentamicin) pending culture results, regardless of clinical condition at birth, duration of maternal antibiotic therapy before delivery, or gestational age at delivery.
1.
How will we identify which mothers were given intrapartum
antibiotics for “suspected chorioamnionitis”?
2.
Do obstetricians need to be made aware that the label of
“suspected chorioamnionitis” has new clinical implications for the
evaluation and treatment of the baby?
Comment:
It now becomes imperative
to ascertain the indication for intrapartum antibiotic treatment.
If the obstetrician is treating suspected chorioamnionitis, then we
automatically need to do a sepsis evaluation and start antibiotics on the
baby. We need a system in place
which assures timely notification of pediatricians or neonatologists when
babies are delivered to women with suspected chorioamnionitis. ABK.
Date: 22 Dec 2002
Time: 21:29:40
The summary recommends "full workup" and abx for infants whose mothers
are dx'd with chorio, regardless of the infant's presentation.
These recommendations do not seem reasonable in light of the overwhelming number
well infants born under these circumstances, the overwhelming number of negative
evaluations performed, and with acknowledgement that ~95% of infants with EOGBS
will be symptomatic within 6 hrs of birth (Bromberger et al, Pediatrics
106:6;244-250).
UserName: Ken Schroeter, DO, FAAP
Institution: Stony Brook University
telephone: 631-444-7653
email: Kenneth.Schroeter@stonybrook.edu
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