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. 2023 Jul 1;9(1):9.
doi: 10.1186/s40748-023-00163-3.

Benzylpenicillin concentrations in umbilical cord blood and plasma of premature neonates following intrapartum doses for group B streptococcal prophylaxis

Amadou Samb  1   2 , Thomas H Dierikx  3   4   5   6 , Yuma A Bijleveld  7 , Timo R de Haan  3   5 , Caspar J Hodiamont  8 , Elisabeth van Leeuwen  3   9 , Anton H L C van Kaam  3   6 , Ron A A Mathôt  7 , Douwe H Visser  3   6
Affiliations

Benzylpenicillin concentrations in umbilical cord blood and plasma of premature neonates following intrapartum doses for group B streptococcal prophylaxis

Amadou Samb et al. Matern Health Neonatol Perinatol. .

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.

Keywords: Benzylpenicillin; GBS prophylaxis; Pharmacology.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
Boxplots of benzylpenicillin concentrations (mg/L) in umbilical cord blood (UCB) and neonatal plasma at birth (N = 9). The left boxplot depicts neonatal plasma concentrations. The right boxplot depicts UCB concentrations
Fig. 2
Fig. 2
Benzylpenicillin concentrations in umbilical cord blood (mg/L) versus time after last intrapartum dose (hours). Points are measured concentrations. The blue line depicts the log-linear regression of the benzylpenicillin concentrations versus time after last intrapartum dose. The shaded area displays the 95% confidence interval of the regression line. The dashed horizontal line depicts the MIC threshold of 0.125 mg/L
See this image and copyright information in PMC

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