Nearly a quarter of the estimated four million women who give birth
each year in the United States receive an antibiotic during labor in order
to protect their infants from developing a serious infection.
But these women may be getting five times the necessary dose of
medication, said Ohio State University researchers.
"Physicians may be using too much penicillin," stated
researcher David Colombo. "There is a shortage of this type of
penicillin -- the kind that is given intravenously. Also, we worry that
the overuse of antibiotics overall will lead to the increased resistance
of harmful bacteria to these drugs."
Penicillin is the most common antibiotic given to a woman at risk of
transferring the bacteria group B Streptococcus (GBS) to her newborn.
Penicillin is thought to protect the baby against GBS, which can cause
sepsis, a sometimes-fatal blood infection.
The Centers for Disease Control and Prevention recommend that these
women get about 3 grams of penicillin (5 million units) when labor begins,
followed by 1.5 grams (2.5 million units) every four hours until delivery.
But a dose of about 0.5 grams (1 million units) given initially and
again every four hours until delivery may give the same protective effect,
said Colombo, an assistant professor of obstetrics and gynecology at Ohio
State.
The study was published in the American Journal of Obstetrics and
Gynecology.
Fifteen healthy pregnant women in their third trimester of pregnancy,
but who were not yet in labor, were given one 0.5-gram dose of intravenous
penicillin. The researchers wanted to analyze the concentration of
penicillin in each woman's blood, so they took blood samples via a
catheter at one, five, 15 and 30 minutes after the initial dose and then
once every 30 minutes for a total of four hours.
They found that this lower dosage of penicillin is excreted from the
body at the same rate as are the 3- and 1.5-gram doses, suggesting that a
lower dosage of penicillin provides levels sufficient enough to protect a
newborn from infection caused by GBS.
"The baby is really the one who is being treated," said
Colombo. "We can give the 0.5 gram doses of penicillin to mothers in
labor and get the same beneficial results as we do with the larger
doses."
SOURCE: "Optimal dosing of penicillin G in the third
trimester of pregnancy for prophylaxis against group B
Streptococcus," American Journal of Obstetrics and Gynecology,
October 2001.