A preprint presents evidence for the hypothesis that neonatal sepsis is linked to prenatal antibiotics.
By Dr. Liji Thomas, MDSep 7 2023Reviewed by Sophia Coveney Neonatal sepsis caused by intestinal pathogens is a serious complication of early infancy that may often be lethal, especially for premature infants. But is this linked to prenatal antibiotics often used to prevent infection following preterm premature rupture of membranes ?
The bacterium called Escherichia coli is the cause of the second-highest number of LOS cases. This bacterium has often been found to be part of the gut microbiota in the neonate before causing infection. Nowadays, broad-spectrum antibiotics are being used more often in pregnancy. This is despite the evidence of earlier studies showing that the risk of LOS, necrotizing enterocolitis , and poor neonatal outcomes is enhanced with broad-spectrum antibiotic use in PPROM.
What did the study show? The findings show a fivefold increase in the risk of LOS in neonates following prenatal treatment with cephalosporins and other broad-spectrum antibiotics like azithromycin in a cohort of infants at risk for this event. The infants were also at higher risk for positive blood cultures. These figures are in comparison to penicillin use.
This effect was not seen with other bacteria, such as group B streptococci, indicating an E. coli-specific decrease in mammary IgA production.