Prevention of perinatal group B streptococcal infection: Current controversies

Group B streptococcus (GBS) is the most frequent cause of neonatal sepsis i n the United States. The Centers for Disease Control and Prevention (CDC) i ssued guidelines for its prevention in 1996. This article details areas of controversy with those guidelines and offers recommendations for resolution . We recommend that a prevention policy be adopted by all hospitals. If a s creening-based policy is chosen, compliance is essential. Penicillin is the antibiotic of choice for GBS prevention. Increasing resistance to clindamy cin and erythromycin might eliminate them as alternative choices in patient s allergic to penicillin. Group B streptococcal prophylaxis might not be ne cessary in women who have repeat elective cesarean delivery. In asymptomati c women, a positive urine culture for GBS should be considered clinically e quivalent to a positive vaginal or rectal sample for screening. Neonatal se psis caused by organisms other than GBS must be monitored carefully by all hospitals providing obstetrics services. (Obstet Gynecol 2000;96:141-5. (C) 2000 by The American College of Obstetricians and Gynecologists.).