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Table 3 Characteristics of studies included in this review of the impact of mass drug administration with antibiotics for intrapartum antibiotic prophylaxis on the human gut microbiome

From: The impact of mass drug administration of antibiotics on the gut microbiota of target populations

Reason for MDA

First author

Year

Study Design

Specimen collection and Sequencing

Country

Target population

Intervention

Major findings

IAP

Aloisio, I [158]

2016

Cross-sectional study

200 mg stool, 16S rRNA gene V2, V3, V4, V6, V7, and V8 amplification and sequencing

Italy

Vaginally delivered, full-term neonates with no prior antibiotic exposure sampled at 6–7 days of age (n = 20)

2 g of IV ampicillin ≤ 4 h before delivery, then 1 g every 4 h during labor until delivery (GBS-positive mothers) versus no IAP (GBS-negative mothers)

40%–50% decreased microbiome diversity, greater abundance of Enterobacteriaceae, and reduced abundance of Bifidobacterium spp.

IAP

Azad, MB [76]

2016

Prospective cohort study

80–200 mg stool, 16S rRNA gene V4 amplification and sequencing

Canada

Full-term infants sampled at 3 and 12 months of age in four comparison groups: (i) no IAP with vaginal delivery, (ii) IAP with vaginal delivery, (iii) IAP with elective CS delivery, and (iv) IAP with emergency CS delivery (n = 198)

IAP in accordance with Canadian practice guidelines predominantly using, cefazolin (CS deliveries), IAP for GBS prophylaxis or pre-labor rupture of membranes predominantly using, penicillin (vaginal delivery)

7% decrease in microbiome diversity with vaginal delivery and IAP at 3 months, and 14% increase in microbiome diversity with CS and IAP at 1 year; greater abundance of bacteria in the Proteobacteria phylum and reduced abundance of bacteria in the Bacteroidetes phylum with IAP at 3 months and 1 year

IAP

Mazzola, G [77]

2016

Prospective cohort study

200 mg stool, 16S rRNA gene V3–V4 amplification and sequencing

Italy

Vaginally delivered, full-term infants with no prior antibiotic exposure sampled at 7 and 30 d in four comparison groups: (i) breast-fed infants born to GBS-negative mothers, not receiving IAP, (i), breast-fed infants born to GBS-positive receiving IAP, (iii) mixed-fed infants born to GBS-negative mothers not receiving IAP, (iv) mixed-fed infants born to GB positive receiving, IAP (n = 26)

2 g IV ampicillin at labor then 1 g every h up to a maximum of 4 g to prevent infant GBS infection (GBS-positive mothers)

Decreased microbiome diversity in breast-fed IAP exposed versus breast-fed IAP unexposed infants, greater abundance of bacteria in the Enterobacteriaceae family and reduced abundance of Bifidobacterium spp. in breast fed infants IAP exposed versus breast-fed IAP unexposed infants

IAP

Nogacka, A [78]

2017

Prospective cohort study

Stool, 16S rRNA gene V3 amplification and sequencing

Spain

Vaginally delivered, full-term neonates with no prior antibiotic exposure sampled at 2, 10, 30, and 90 days of age (n = 40)

5 million units of penicillin followed by 2.5 million units every 4 h until delivery (GBS-positive or suspected mothers) versus no IAP (GBS-negative mothers)

Reduced abundance of bacteria in the Actinobacteria phylum at 10 days and increased abundance of bacteria Firmicutes phylum at 10 and 90 days

IAP

Stearns, JC [75]

2017

Prospective cohort study

100–200 mg stool, 16S rRNA gene V3 amplification and sequencing

Canada

Vaginally delivered, full-term, singleton infants sampled at 3 d, 10 d, 6 weeks and 12 weeks (n = 74)

IAP with penicillin G, cefazolin, ampicillin, cephalexin to prevent infant GBS infection versus no IAP

More phylogenetically similar microbiome composition with IAP at 6 weeks of age, and reduced abundance of Bifidobacterium spp. and increased abundance of bacteria in the Enterobacteriaceae family at 6 and 10 weeks

IAP

Kamal, SS [79]

2019

RCT

200 mg stool, 16S rRNA gene V3-V4 amplification and sequencing

Denmark

Cesarean delivered infants sampled at 10 d and 9 months of age (n = 42)

Single dose of IV 1,500 mg cefuroxime administered 15–60 min prior to surgical incision versus immediately after umbilical cord clamping

15%–37% greater microbiome diversity in infants born to mothers who received IAP immediately after cord-clamping at 9 months

IAP

Coker, MO [74]

2020

Prospective cohort study

Stool, 16S rRNA gene V4–V5 amplification and sequencing

United States of America

Vaginally delivered, full-term infants sampled at 6 weeks and 12 months of age (n = 266)

Maternal antibiotic use for prevention of infant GBS infection categorized into the five groups: (i) no IAP, (ii) penicillin like only (amoxicillin, penicillin), (iii) cephalosporins only (cefazolin, cephalexin), (iv) multi-drug classes (two or more drugs under the category of penicillin, cephalosporin, vancomycin, clindamycin and/or gentamicin), and (v) other classes (aminoglycosides, glycopeptides or lincomycin only)

Decreased in microbiome diversity at 6 weeks with penicillin-like IAP and at 1 year with multiclass IAP; reduced abundance of Bifidobacterium spp. and Bacteroides spp. at 6 weeks and 1 year with penicillin-like IAP

IAP

Zhou, P [159]

2020

Cross-sectional study

Neonatal meconium, 16S rRNA gene V4 amplification and sequencing

China

Vaginally delivered singleton, full-term or pre-term neonates with no prior antibiotic exposure sampled at birth (n = 98)

2 g IV cefazolin every 12 h ≤ 48 h before delivery for the prevention of GBS newborn infection versus no IAP

Greater similarity in meconium microbiome composition among infants born to mothers who received IAP