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Persistence of Penicillin G Benzathine in Pregnant Group B Streptococcus Carriers.

WEEKS, JONATHAN W. MD; MYERS, STEVEN R. PhD; LASHER, LISA MD; GOLDSMITH, JANE PhD; WATKINS, CHRISTOPHER MD; GALL, STANLEY A. MD
Obstetrics & Gynecology:
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Abstract

Objective: To determine if streptococcicidal levels of penicillin G benzathine can be detected in maternal serum 4 weeks after treatment with 4.8 million units.

Methods: Thirty-seven pregnant women with positive group B streptococcus vaginal or urine cultures were each given 4.8 million units of penicillin G benzathine. Maternal blood samples were collected after injection and at delivery. Serum penicillin levels were measured by high-pressure liquid chromatography. Follow-up cultures were done when possible.

Results: None of the patients had serum penicillin levels below 0.20 [mu]g/mL 30 days after treatment. Cord blood levels were approximately 50% lower than maternal levels. In all but three subjects, cord blood levels exceeded 0.06 [mu]g/mL, the minimal inhibitory concentration for group B streptococcus. The three exceptions were patients who delivered more than 100 days after treatment. Group B streptococcus cultures were negative at the time of delivery in 72% of cases. None of the patients with positive cultures were moderately or heavily colonized.

Conclusion: In pregnant women, penicillin G benzathine levels are high enough to inhibit the growth of group B streptococcus for more than 4 weeks after injection with 4.8 million units. Further studies are needed to evaluate whether this regimen can prevent neonatal colonization and invasive group B streptococcus disease.

(C) 1997 The American College of Obstetricians and Gynecologists

In Brief

Streptococcicidal levels of penicillin G benzathine can be dected in the serum of pregnant patients 4-6 weeks after injection with 4.5 million units.