Bennet et al. evaluated the microflora of newborns during intensive care therapy and treatment with five antibiotic regimens (56). Aerobic and anaerobic fecal bacterial flora of normal newborns, preterm newborn infants without other health problems, and five groups of newborn infants treated with combinations of benzylpenicillin, cloxacillin, flucloxacillin, ampicillin, cefuroxime, cefoxitin, and gentamicin were compared. Preterm birth alone was associated with growth of Klebsiella which could be attributed to a higher rate of cesarean section in preterm than in term infants. All antibiotic regimens led to a pronounced suppression of anaerobic flora and overgrowth of Klebsiella but not with other aerobic gram negative bacilli. Minimal colonization with C. difficile and C. perfringens occurred. The authors concluded that disturbances of the intestinal microbial ecology can be expected in newborn infants after preterm birth by cesarean section and/or treatment with antibiotics, including some penicillins that are usually regarded as relatively harmless in this respect in adults.
Treatment with antibiotics was not associated with occurrence of C. perfringens. However, in infants with C. perfringens, intrapartum antibiotics were associated with increased appearance of abdominal distension (p <0.05).
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