title: Survey of American obstetricians regarding group B streptococcus: opinions and practice patterns.
abstract: OBJECTIVE
  The objective of the study was to evaluate attitudes and practice patterns of obstetricians related to screening for group B streptococcal colonization and providing intrapartum antibiotic prophylaxis against early-onset neonatal infections with group B streptococcus.
  
  
  METHODS
  We mailed a survey to 546 members of the American College of Obstetricians and Gynecologists, including members of the Collaborative Ambulatory Research Network and non-Collaborative Ambulatory Research Network members. Stratified random selection was used to generate samples from both of these groups.
  
  
  RESULTS
  The survey response rate was 60% for Collaborative Ambulatory Research Network members and 42% for non-Collaborative Ambulatory Research Network members. Of the 206 respondents who reported providing prenatal care, 97% collect screening samples at 35-37 weeks' gestational age. Anatomic sites used to collect samples were more variable: 62% include lower vagina and rectum, 26% include lower vagina and perianal skin but not rectum, and 5% include neither the perianal skin nor the rectum. First-line agents for intrapartum antibiotic prophylaxis were penicillin (71%), ampicillin (27%), and cefazolin (2%). For patients reporting a nonanaphylactic penicillin allergy, drugs used for intrapartum antibiotic prophylaxis were more varied: cefazolin (51%), clindamycin (36%), vancomycin (8%), and erythromycin (5%). For patients undergoing a labor induction starting with a cervical ripening agent, less than 40% typically give the first dose of intrapartum antibiotic prophylaxis before or at the time of cervical ripening agent administration, and 15% wait until the patient reaches the active phase of labor.
  
  
  CONCLUSIONS
  Gaps in knowledge and reported practice related to the prevention of early-onset neonatal group B streptococcus infections were similar to gaps in implementation of guidelines demonstrated in past studies. New approaches to improve implementation are warranted.
authors: Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL. Electronic address: rke@uab.edu.
authors: Rodney K
authors: RK
authors: Edwards
authors: Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL.
authors: Ying
authors: Y
authors: Tang
authors: American College of Obstetricians and Gynecologists, Washington, DC.
authors: Greta B
authors: GB
authors: Raglan
authors: Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL.
authors: Jeff M
authors: JM
authors: Szychowski
authors: American College of Obstetricians and Gynecologists, Washington, DC.
authors: Jay
authors: J
authors: Schulkin
authors: Centers for Disease Control and Prevention, Atlanta, GA.
authors: Stephanie J
authors: SJ
authors: Schrag
mesh_terms: D000328:Adult; D000667:Ampicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D058345:Asymptomatic Infections; D001291:Attitude of Health Personnel; D002353:Carrier State / Q000175:diagnosis / Q000188:drug therapy*; D002437:Cefazolin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000517:prevention & control*; D007743:Labor, Obstetric; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009774:Obstetrics; D010406:Penicillins / Q000627:therapeutic use; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D013290:Streptococcal Infections / Q000175:diagnosis / Q000517:prevention & control*; D013292:Streptococcus agalactiae; D014481:United States
chemical_list: D000900:Anti-Bacterial Agents; D010406:Penicillins; D000667:Ampicillin; D002437:Cefazolin
keywords: early-onset neonatal infection; group B streptococcus; intrapartum antibiotic prophylaxis; screening