Table 7.5Evidence profile for intramuscular benzylpenicillin (50,000 IU) administered to all babies within 1 hour of birth versus no benzylpenicillin prophylaxis

Number of studiesNumber of babiesEffectQuality
Intramuscular benzylpenicillin within 1 hour of birthNo benzylpenicillin prophylaxisRelative (95% confidence interval)Absolute (95% confidence interval)
Clinical sepsis
All neonates
1 (Patel 1999)96/5389
(1.8%)
140/5609
(2.5%)
RR 0.71 (0.55 to 0.92)*7 fewer per 1000 (from 2 fewer to 11 fewer)Very low
Preterm neonates
1 (Patel 1999)86/1400
(6.1%)
112/1464
(7.7%)
RR 0.8 (0.61 to 1.05)*15 fewer per 1000 (from 30 fewer to 4 more)Very low
Term neonates
1 (Patel 1999)10/3989
(0.3%)
31/4145
(0.7%)
RR 0.34 (0.16 to 0.68)*5 fewer per 1000 (from 2 fewer to 6 fewer)Very low
Identified sepsis
All neonates
1 (Patel 1999)35/5389
(0.6%)
67/5609
(1.2%)
RR 0.54 (0.36 to 0.82)*5 fewer per 1000 (from 2 fewer to 8 fewer)Very low
Preterm neonates
1 (Patel 1999)27/1400
(1.9%)
43/1464
(2.9%)
RR 0.66 (0.41 to 1.06)*10 fewer per 1000 (from 17 fewer to 2 more)*Very low
Term neonates
1 (Patel 1999)8/3989
(0.2%)
24/4145
(0.6%)
RR 0.35 (0.16 to 0.77)*4 fewer per 1000 (from 1 fewer to 5 fewer)*Very low
Group B streptococcus
All neonates
1 (Patel 1999)22/5389
(0.4%)
52/5609
(0.9%)
RR 0.44 (0.27 to 0.72)*5 fewer per 1000 (from 3 fewer to 7 fewer)*Very low
Preterm neonates
1 (Patel 1999)15/1400
(1.1%)
33/1464
(2.3%)
RR 0.48 (0.26 to 0.87)*12 fewer per 1000 (from 3 fewer to 17 fewer)*Very low
Term neonates
1 (Patel 1999)7/3989
(0.2%)
19/4145
(0.5%)
RR 0.38 (0.1611 to 0.9097)*3 fewer per 1000 (from 0.4 fewer to 4 fewer)*Very low
Group B streptococcus blood culture
All neonates
1 (Patel 1999)6/5389
(0.1%)
58/5609
(1%)
RR 0.5 (0.32 to 0.79)*3 fewer per 1000 (from 1 fewer to 3 fewer)*Very low
Preterm neonates
1 (Patel 1999)2/1400
(0.1%)
12/1464
(0.8%)
RR 0.17 (0.04 to 0.78)*7 fewer per 1000 (from 2 fewer to 8 fewer)*Very low
Term neonates
1 (Patel 1999)4/3989
(0.1%)
9/4145
(0.2%)
RR 0.46 (0.14 to 1.5)*1 fewer per 1000 (from 2 fewer to 1 more)*Very low
Mortality due to clinical or identifiable sepsis
All neonates
1 (Patel 1999)4/5389
(0.1%)
16/5609
(0.3%)
RR 0.26 (0.09 to 0.78)*2 fewer per 1000 (from 1 fewer to 3 fewer)*Very low
Preterm neonates
1 (Patel 1999)4/1400
(0.3%)
10/1464
(0.7%)
RR 0.42 (0.13 to 1.33)*4 fewer per 1000 (from 6 fewer to 2 more)*Very low
Term neonates
1 (Patel 1999)0/3989
(0%)
7/4145
(0.2%)
RR 0.07 (0.004 to 1.212)*2 fewer per 1000 (from 2 fewer to 0.4 more)*Very low

RR relative risk

*

Calculated by the NCC-WCH technical team from data reported in the article; it is not clear whether more than one organism was isolated in any baby

See the complete GRADE Table J 7.5

Calculated by the NCC-WCH technical team from data reported in the article; it is not clear whether more than one organism was isolated in any baby

From: 7, Routine antibiotics after birth

Cover of Antibiotics for Early-Onset Neonatal Infection
Antibiotics for Early-Onset Neonatal Infection: Antibiotics for the Prevention and Treatment of Early-Onset Neonatal Infection.
NICE Clinical Guidelines, No. 149.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2012 Aug.
Copyright © 2012, National Collaborating Centre for Women’s and Children’s Health.

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