title: Group B Streptococcus prophylaxis in patients who report a penicillin allergy: a follow-up study.
abstract: OBJECTIVE
  The purpose of this study was to compare adherence to the 2002 Centers for Disease Control (CDC) guidelines for the prevention of perinatal group B Streptococcus (GBS) disease in patients who are allergic to penicillin during the years 2004-2006 and 2008.
  
  
  METHODS
  Previous data from our institution revealed suboptimal adherence to the 2002 CDC guidelines for GBS prophylaxis among women who are allergic to penicillin. These data caused the hospital to implement a series of interventions. The original cohort (2004-2006) was compared with a cohort of women who delivered between April 2008 and January 2009 (n = 74) to determine whether the proportion of women who had antimicrobial sensitivity testing and who had received an appropriate antibiotic had improved.
  
  
  RESULTS
  In 2008, 76% (95% confidence interval, 66-84%) of GBS-positive women who are allergic to penicillin received an appropriate antibiotic (compared with 16.2% in 2004-2006; P < .001). Antimicrobial sensitivity testing was performed in 79.4% of cases (95% confidence interval, 68-87%), compared with 11.4% in 2004-2006 (P < .001).
  
  
  CONCLUSIONS
  With directed intervention, adherence to the 2002 CDC guidelines for GBS prophylaxis in women who are allergic to penicillin improved dramatically.
authors.affiliation: Division of Research, Department of Obstetrics and Gynecology, Women and Infants Hospital, The Warren Alpert Medical School at Brown University, Providence, RI, USA.
authors.forename: Agatha S
authors.initials: AS
authors.lastname: Critchfield
authors.forename: Stacey P
authors.initials: SP
authors.lastname: Lievense
authors.forename: Christina A
authors.initials: CA
authors.lastname: Raker
authors.forename: Kristen A
authors.initials: KA
authors.lastname: Matteson
mesh_terms: D019072:Antibiotic Prophylaxis; D002487:Centers for Disease Control and Prevention, U.S.; D004342:Drug Hypersensitivity / Q000276:immunology*; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence; D006801:Humans; D010406:Penicillins / Q000009:adverse effects* / Q000276:immunology; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology / Q000517:prevention & control*; D012189:Retrospective Studies; D013290:Streptococcal Infections / Q000276:immunology / Q000517:prevention & control*; D013292:Streptococcus agalactiae / Q000276:immunology*; D014481:United States
chemical_list: D010406:Penicillins