Prevention of neonatal group B streptococcal disease: A combined intrapartum and neonatal protocol.
OBJECTIVE
We sought to assess the efficacy of a clinical protocol to reduce the incidence of early-onset neonatal group B Streptococcus (GBS) infection.


METHODS
We assessed neonatal sepsis from GBS and other organisms with use of a before-after study design to evaluate the effects of implementation of combined intrapartum antimicrobial prophylaxis given selectively to mothers with GBS risks and penicillin G given to all neonates.


RESULTS
In 1994, early-onset GBS infection developed in 31 of 13,887 live births (2.2/1000), 13 preterm and 18 term cases. After implementation of the prophylaxis protocol (1995), 6 of 13,527 live births had early-onset GBS (0.4/1000) (P <.001). There were no preterm (P =.0004) and 6 term GBS cases (P =.02). The efficacy continued through 1999 (0.5/1000) without an increase in neonatal infections from other bacteria.


CONCLUSIONS
Combined maternal and infant antimicrobial prophylaxis can significantly and safely reduce rates of early-onset GBS infection in both preterm and term infants.
Wendel
George D
GD
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, 75390-9032, USA. george.wendel@utsouthwestern.edu.
Leveno
Kenneth J
KJ
Sánchez
Pablo J
PJ
Jackson
Gregory L
GL
McIntire
Donald D
DD
Siegel
Jane D
JD
D000465:Algorithms; D000667:Ampicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002821:Chorioamnionitis / Q000188:drug therapy; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007743:Labor, Obstetric; D010400:Penicillin G / Q000008:administration & dosage; D011247:Pregnancy; D044469:Racial Groups; D012307:Risk Factors; D013290:Streptococcal Infections / Q000453:epidemiology / Q000517:prevention & control*; D013292:Streptococcus agalactiae
D000900:Anti-Bacterial Agents; D005839:Gentamicins; D000667:Ampicillin; D010400:Penicillin G