Novobiocin and Neonatal Hyperbilirubinemia

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Abstract
An epidemic of apparent neonatal jaundice occurred with novobiocin administration to control a staphylococcal outbreak in a newborn nursery. The epidemic increase in clinical neonatal jaundice prompted studies and review of the relationship between novobiocin, so-called yellow novobiocin intermediary metabolites, and bilirubin. Jaundice Epidemic in a Newborn Nursery In early 1959, a staphylococcal outbreak was encountered in a term newborn nursery. The responsible organism was sensitive (disc sensitivity) to novobiocin but only partially sensitive to erythromycin. The outbreak was treated by administration of novobiocin to all infants admitted to the nursery. Every 8 hours, 50 gm. was given, a dose used in another local nursery during a similar outbreak. The number of clinically jaundiced infants increased during the period of novobiocin administration. This was documented by tabulation of infants with serum bilirubin determined to be over 15 mg. per 100 ml. during the period of novobiocin administration, during the preceding

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