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Question: ID

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A seven day old neonate is brought in for a fever of 38.5 and lethargy. The baby had a home birth, and the parents have chosen a “lotus birth,” or umbilical nonseverance. The placenta remains attached to the newborn (carried around with the baby, often in a small bag), until it separates on its own, typically in 5-15 days. 

What antibiotic should you administer in addition to the usual empiric antibiotics for neonatal sepsis in the case of lotus birth?

pemsou5_wp • March 15, 2022

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  1. Kelly March 16, 2022 - 10:06 pm Reply

    B) Vancomycin
    Lotus birth has been associated with neonatal sepsis and endocarditis due to coagulase negative staph species, hence the recommendation to add vancomycin. Another alternative birth practice, water immersion birth, has been associated with pseudomonas (piperacillin-tazobactam) and legionella (erythromycin). A recent review of infectious diseases associated with alternative perinatal practices was published in Pediatrics

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