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Antibody Production in Normal Children Receiving Penicillin at Birth^1,2,

From the Department of Dermatology, New York University School of Medicine, and the Department of Pediatrics, The Mount Sinai School of Medicine and City Hospital Center at Elmhurst, New York

Abstract

Serial determinations of serum penicillin antibody and immunoglobulin G, A, and M concentrations were performed from birth in 159 normal infants, 69 of whom received parenteral penicillin at birth as prophylaxis for gonococcal ophthalmia, and 90 of whom were treated by a non-penicillin method of prophylaxis. Low levels of penicilloyl-specific IgM antibodies were present in 15/159 (9%) cord sera. This was shown to represent active fetal synthesis following prenatal exposure. Penicilloylspecific IgM antibodies were detected at 1 year of age in 1/22 (5%) infants who never received penicillin therapy, in 12/36 (33%) infants who received penicillin therapy only at birth, and in 15/27 (56%) infants who received penicillin therapy both at birth and subsequently. Penicilloyl-specific IgM antibodies were detected at 5 years of age in 11/17 (65%) children who received penicillin therapy only after the neonatal period, and in 8/10 (80%) children who received penicillin both at birth and subsequently. Penicilloyl-specific IgM antibodies were detected in 486/600 (81%) adults who received penicillin only after the neonatal period. There was a statistically significant greater incidence of penicilloyl-specific IgM antibodies at 1 year of age in the group treated only at birth vs the group who received no penicillin therapy. There was also a statistically significant greater incidence of penicilloylspecific IgM antibodies in the adults who received penicillin therapy after the neonatal period as compared to the 1-year-old children who received penicillin therapy only at birth or at birth and subsequently. These differences were no longer present by 5 years of age. None of the 10 children studied at 5 years of age who had received penicillin at birth had penicilloyl-specific IgG antibodies, delayed skin test reactivity or skin-sensitizing antibodies. No adverse reactions were noted in any of the children studied. It appears that although penicillin therapy at birth is associated with an earlier onset of demonstrable penicilloyl-specific IgM antibodies, this difference is no longer present by 5 years of age, at which time the incidence resembles that observed in adults.

Footnotes

¹ This work was supported in part by United States Public Health Service Research Grant A1-07728 from the National Institute of Allergy and Infectious Diseases.

² Presented in part at the 31st Annual Meeting of the Society for Investigative Dermatology, June 20 to 21, 1970, Chicago, Illinois.

³ New York University School of Medicine. Address requests for reprints to: Dr. Fellner, 550 1st Ave., New York, N.Y.

⁴ The Mount Sinai School of Medicine of the City University of New York and City Hospital Center at Elmhurst, N. Y.