title: Efficacy of intramuscular penicillin in the eradication of group B streptococcal colonization at delivery.
abstract: OBJECTIVE
  Due to rapid deliveries and human error, not all group B streptococcal positive mothers will receive adequate prophylactic antibiotic treatment in labor. We sought to determine if long acting intramuscular penicillin given after a positive culture result would be efficacious in eradicating group B streptococcal colonization at the time of delivery.
  
  
  METHODS
  Patients positive for group B streptococci at 35-37 weeks were randomized to receive 2.4 million units of intramuscular benzathine penicillin G suspension (Bicillin L-A) versus no treatment. Study patients were recultured at the time of admission to labor and delivery prior to receiving prophylactic antibiotics according to CDC guidelines.
  
  
  RESULTS
  A total of 53 patients were enrolled. A small but significant decrease in the rate of group B streptococcal colonization was observed in the treatment group (14/27, 52%) versus the control group (20/23, 87%), p=0.03.
  
  
  CONCLUSIONS
  The large number of persistent carriers suggests that 2.4 million units of intramuscular benzathine penicillin G suspension (Bicillin L-A) is insufficient as sole therapy. However, the decline in group B streptococcal carriers might lessen the risk of failed or insufficient intrapartum treatment. Intramuscular benzathine penicillin G suspension (Bicillin L-A) may be useful as an adjunctive treatment for patients at risk for rapid delivery, before adequate intrapartum prophylaxis can be given.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Maine Medical Center, Portland, Maine 04102, USA.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Pinette
authors.forename: Katharine
authors.initials: K
authors.lastname: Thayer
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Wax
authors.forename: Jacquelyn
authors.initials: J
authors.lastname: Blackstone
authors.forename: Angelina
authors.initials: A
authors.lastname: Cartin
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D015169:Colony Count, Microbial; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D010401:Penicillin G Benzathine / Q000008:administration & dosage*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D011295:Prenatal Care / Q000379:methods; D011446:Prospective Studies; D013290:Streptococcal Infections / Q000188:drug therapy*; D013292:Streptococcus agalactiae; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D010401:Penicillin G Benzathine