Which class of antibiotic can interfere with bilirubin binding to protein in newborns?

The correct answer is sulfas. Sulfonamide antibiotics, commonly referred to as sulfas, are known to displace bilirubin from albumin binding sites in newborns. This is particularly important in the context of neonatal care because high levels of unconjugated bilirubin can lead to kernicterus, a form of brain damage resulting from jaundice.

In newborns, bilirubin levels can be elevated due to the immature hepatic metabolism and decreased ability to conjugate bilirubin. Sulfonamides can exacerbate this condition by competing with bilirubin for binding sites, leading to an increased free bilirubin level in the bloodstream. This effect is why sulfas are typically contraindicated in neonates, especially during the first month of life, to prevent potential neurological damage associated with elevated bilirubin levels.

Aminoglycosides, penicillins, and tetracyclines do not have this particular effect on bilirubin binding. While each antibiotic class has its specific uses and potential side effects, they do not interfere with bilirubin's binding to proteins in the same way that sulfas do. Understanding the implications of these interactions is crucial in maternal-newborn nursing practice, especially for medication management in neonates.