The authors studied in the Paediatric Department of the Leverkusen Municipal Hospital retrospectively the influence of an early dose of
antibiotics (broad-spectrum
penicillin combined with an
aminoglycoside) in respect of the manifestation of bacterial newborn
infections in infants with an increased risk of
infection, during a period of 3 years (1981-1983). Among the infants born in the Gynaecological Department of the Leverkusen Municipal Hospital (exact data were available on the number of births and referrals) the incidence of bacterial newborn
infections was 3.3% referred to the total number of deliveries (n = 3598); 0.7% of these newborn has
sepsis. In the total group of children treated for newborn
infection, the
infection mortality was 5.5%; the mortality of the manifest newborn
sepsis was 16.2%, i.e. lower than reported in literature. Early administration of
antibiotics proved particularly effective in preventing purulent
bacterial meningitis of newborn; this disease did not occur with any of the infants observed during the study period. Diagnosis of newborn
infection included discolouration of the skin, respiratory disturbances,
fever, shift to the left in the differential blood picture, and anaemia; these signs proved particularly suitable for arriving at a correct diagnosis. Identification of the pathogens was most frequently successful in gastric juice culture and anal smear. The latency period of more than 24 hours between
rupture of the amnion and delivery does not represent an increased risk of
infection for the newborn, as our results confirm, and this is, therefore, not an indication for initiating prophylaxis with
antibiotics if there are no other abnormal findings.