Duration of Intrapartum Prophylaxis for Neonatal Group B Streptococcal Disease

Illuzzi, Jessica L.; Bracken, Michael B.

doi:10.1097/01.aog.0000241539.86451.11

Cited by 47 publications

(26 citation statements)

References 36 publications

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“…Even though not ideal, duration of IAP 2 hours can provide acceptable coverage [131,[133][134][135]. In cases of less than acceptable coverage (52 hours) the neonatologist should be informed.…”

Section: Intrapartum Antibiotic Prophylaxismentioning

confidence: 99%

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Renzo

Melin²,

Berardi

et al. 2014

The Journal of Maternal-Fetal & Neonatal Medicine

156

135

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Group B streptococcus (GBS) remains worldwide a leading cause of severe neonatal disease. Since the end of the 1990s, various strategies for prevention of the early onset neonatal disease have been implemented and have evolved. When a universal antenatal GBS screening-based strategy is used to identify women who are given an intrapartum antimicrobial prophylaxis, a substantial reduction of incidence up to 80% has been reported in the USA as in other countries including European countries. However recommendations are still a matter of debate due to challenges and controversies on how best to identify candidates for prophylaxis and to drawbacks of intrapartum administration of antibiotics. In Europe, some countries recommend either antenatal GBS screening or risk-based strategies, or any combination, and others do not have national or any other kind of guidelines for prevention of GBS perinatal disease. Furthermore, accurate population-based data of incidence of GBS neonatal disease are not available in some countries and hamper good effectiveness evaluation of prevention strategies. To facilitate a consensus towards European guidelines for the management of pregnant women in labor and during pregnancy for the prevention of GBS perinatal disease, a conference was organized in 2013 with a group of experts in neonatology, gynecologyobstetrics and clinical microbiology coming from European representative countries. The group reviewed available data, identified areas where results were suboptimal, where revised procedures and new technologies could improve current practices for prevention of perinatal GBS disease. The key decision issued after the conference is to recommend intrapartum antimicrobial prophylaxis based on a universal intrapartum GBS screening strategy using a rapid real time testing.

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Section: Intrapartum Antibiotic Prophylaxismentioning

confidence: 99%

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Renzo

Melin²,

Berardi

et al. 2014

The Journal of Maternal-Fetal & Neonatal Medicine

156

135

View full text Add to dashboard Cite

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“…IAP to GBS carriers reduces the incidence of GBS-EOD [14][15][16][17][18] . However, prevention strategies for GBS disease are currently based on two different approaches: risk based and screening based.…”

mentioning

confidence: 99%

Timing of Group B Streptococcus Screening in Pregnancy: A Systematic Review

Berg¹,

Houtman-Roelofsen²,

Oostvogel

et al. 2009

Gynecol Obstet Invest

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Background: Group B streptococcus (GBS) is an important cause of neonatal sepsis. Guidelines advise to collect cultures at 35–37 weeks’ gestation and to administer intrapartum antibiotic prophylaxis in case of GBS-positive cultures, as well as in all preterm deliveries. Improved effectiveness of antenatal cultures might help to further decrease GBS early-onset disease. Objective: To determine the best timing of antenatal cultures, which may help establish optimal prevention of perinatal GBS infection in both term and preterm neonates. Methods: PubMed and EMBASE databases were searched for relevant articles published from 1966 to February 2009. Nine articles were included. Information about study features and predictive values of antenatal cultures were abstracted. Results: Positive predictive values for antenatal GBS cultures ranged from 43 to 100% (mean 69%) and negative predictive values from 80 to 100% (mean 94%). GBS cultures collected in late pregnancy had high positive predictive values for colonization during delivery. The negative predictive value was high and relatively constant regardless of GA. Conclusions: This systematic review confirms recommendations to screen pregnant women for colonization of GBS at 35–37 weeks’ gestation, but one should be aware of the limitations of screening, with 6% of GBS carriers remaining undetected in antenatal cultures.

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“…Illuzzy et Bracken ont fait une méta-analyse reprenant les données de quatre études utilisant l'ampicilline pour l'antibioprophylaxie. Ils montrent que l'antibioprophylaxie réduit la colonisation et les IBNP à SB à partir d'une heure surtout s'il existe des facteurs de risque associés [2,16,23,27,28]. Par ailleurs, Colombo et al, en 2006, montraient que l'on obtient un taux bactéricide d'ampicilline dans le sang du cordon à partir de 30 minutes après l'injection chez la femme enceinte [29].…”

Section: Discussionunclassified

“…L'infection bactérienne néo-natale précoce qui apparaît dans les 72 premières heures de vie est presque exclusivement due à une transmission maternofoetale [1]. La transmission se fait par voie ascendante ou lors du passage par la filière vaginale et très rarement par voie hématogène [2].…”

Section: Introductionunclassified