Main Article Content
infection in neonates with meconium-stained amniotic fluid
(MSAF) remains unclear. Not all neonates with MSAF develop
meconium aspiration syndrome (MAS) or neonatal infection.
Furthermore, neonatal infection diagnosis may be difficult due
to lack of symptoms. As such, clinical manifestations, laboratory
results, and infection markers are important for diagnosis.
Objective To evaluate antibiotic use on the incidence ofinfection
in neonates with MSAF.
Methods This double-blind randomized controlled clinical trial
was performed at Dr. Kariadi Hospital, Semarang, Indonesia from
October 2009 to March 2010. Subjects were newborns with MSAF
who were diagnosed by two observers (Kappa test intraobserver
agreement was 0.74) and with feces metabolites found in their
amniotic fluid. Sixty-nine newborns were divided into groups I
and II, comprised of 35 and 34 subjects, respectively. Group I
subjects (control group) were not given antibiotics, while group
II subjects (treatment group) were given combination antibiotics
of ampicillin (50 mg;kg BW) and gentamicin (8 mg;kg BW), as
single doses. Neonatal infection diagnosis was based on clinical
manifestations, laboratory results (leucocyte count, blood culture,
and I: T ratio), and the following infection markers: procalcitonin
(PCT), interleukin-6 (IL-6), tumor necrosis tumor-a (TNF-a),
and C-reactive protein (CRP). Chi-square and Fischer's exact
tests were used for statistical analyses.
Results We found no significant differences in the incidence of
neonatal infection between those who received and those who
did not receive antibiotics, based on clinical manifestations, the
first and second examination of laboratory marker (P=0.53),
examinations of CRP, IL-6, TNF-a, and PCT either as single
markers or combinations of 2, 3, or 4 markers (P> 0.05) , as well
as mortality rate (P=0.30).
Conclusion There is no significant difference in the incidence
of infection in neonates with MSAF who received prophylactic antibiotics compared to those who did not receive antibiotics.
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