MANAGEMENT OF ASYMPTOMATIC TERM NEONATES WHOSE MOTHERS RECEIVED INTRAPARTUM ANTIBIOTICS .2. DIAGNOSTIC-TESTS AND MANAGEMENT STRATEGIES

The evaluation of the potentially septic newborn is often a source of frustration for practitioners. In the past, it has often been standard practice to evaluate and treat empirically all neonates whose mothers received antibiotics during labor, regardless of whether the infant h ad any signs or symptoms suggestive of infection, With the advent of r ecommendations for intrapartum antibiotic therapy to prevent early-ons et neonatal group B streptococcal infections, this strategy is no long er practicable because too many infants would thus be evaluated and tr eated needlessly This two-part review addresses the issues involved in managing-asymptomatic newborns whose mothers received intrapartum ant ibiotics. Part I, published separately reviewed the rationale behind s trategies for preventing intrapartum transmission of bacterial infecti on. This final part addresses the evaluation and management of the new born. A number of diagnostic tests are often used in looking for bacte rial infections in the neonate. Unfortunately none of these is both ra pid and reliable, A clinical pathway provided here can serve as a usef ul guide for the clinician, but uncertainty will always remain. Ultima tely, each practitioner must determine the degree of risk or uncertain ty that he or she can accept on the basis of clinical experience.