Compliance with a protocol for intrapartum antibiotic prophylaxis against neonatal group B streptococcal sepsis in women with clinical risk factors.
OBJECTIVE
The aim of this study was to determine the prevalence of clinical risk factors (CRF) for neonatal sepsis in laboring women and to evaluate clinician compliance with a CRF-based protocol for intrapartum antibiotic prophylaxis (IAP).


METHODS
A retrospective chart audit was undertaken at a district hospital (A) and a tertiary obstetric hospital (B) in Sydney, Australia between 1996 and 1998, to determine compliance with IAP in women with defined CRF.


RESULTS
Eighty-five (12%) women at Hospital A and 117 (19%) at Hospital B had one or more CRF. Overall compliance rates with the IAP protocols were 65 and 50% at Hospitals A and B respectively, but varied according to maternal, obstetric and sepsis-related risk factors. We postulate that differences between the hospitals were related to protocol implementation.


CONCLUSIONS
Compliance with a CRF-based protocol was lower than previously reported. Improvements in protocol development, implementation and maintenance are required to enhance compliance with IAP based on CRF.
Sanders
Toni R
TR
Department of Public Health, University of Sydney, Australia. TSanders@csdgp.com.au
Roberts
Christine L
CL
Gilbert
Gwendolyn L
GL
D000328:Adult; D019072:Antibiotic Prophylaxis / Q000592:standards*; D036861:Delivery, Obstetric; D005260:Female; D005865:Gestational Age; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006764:Hospitals, Community / Q000592:standards; D006771:Hospitals, Maternity / Q000592:standards; D006801:Humans; D007231:Infant, Newborn; D007743:Labor, Obstetric; D008499:Medical Records; D009517:New South Wales / Q000453:epidemiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000517:prevention & control*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology / Q000517:prevention & control*; D013290:Streptococcal Infections / Q000453:epidemiology / Q000517:prevention & control*; D013292:Streptococcus agalactiae / Q000302:isolation & purification