Prophylactic Antibiotics For Group B Strep?

I have Group B strep and my doctors have told me that I will need to be given antibiotics while in labor. Do I really need them, and will my newborn also need antibiotics?


Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

Group B strep (GBS), a common pathogen in the vaginal tract of many women, may cause invasive disease in pregnant women and their newborn infants.

It is the second most common cause of bacterial urinary tract infections during pregnancy and a frequent cause of infection of the fetal membranes, the uterus and postpartum fever and infection. GBS is the most common cause of sepsis (blood infection) and meningitis (infection of the fluid and lining surrounding the brain) in newborns. It is also a frequent cause of newborn pneumonia It is the leading cause of serious perinatal infection and death in the U.S. as well as in most developed countries.

Since 1970 we have seen a 50 percent reduction in deaths from GBS due to improvements in the diagnosis and management of this infection. The actual incidence of the disease, however, has remained unchanged over this period.

Studies demonstrate the effectiveness of antibiotic therapy in eliminating GBS disease when it is administered just prior to delivery. GBS disease can be eliminated in newborns of mothers who are lightly or heavily colonized.

Your baby will benefit from the antibiotics you receive while in labor and the infection risk can be reduced very significantly. In some studies it was reduced to zero when the mother was given treatment in labor.

Treatment of mothers during pregnancy has not eradicated the disease. Prenatal treatment can reduce colonization in the short term, but relapse often occurs. Recolonization still occurs in two-thirds of cases by the time of delivery.

Next: Find out if GBS will affect treatment of your newborn

Routine use of antibiotics for infants born to mothers who have received intravenous antibiotics during labor is not recommended. However, antibiotic use is appropriate for infants with suspected sepsis. .

For infants without symptoms whose mothers have received intravenous antibiotics during labor, those with gestations of less than 35 weeks should have a limited diagnostic evaluation -- complete blood count and differential, and blood culture -- and be observed in the hospital for at least 48 hours (no early discharge). If during hospital observation signs of systemic infection develop, a complete diagnostic evaluation should be performed, and antibiotic therapy should be initiated.

In asymptomatic infants with a gestational age of 35 weeks or longer, the duration of intravenous antibiotic use before delivery determines subsequent management. If two or more doses of antibiotics were given before delivery, no laboratory evaluation or antibiotic therapy is recommended. These infants should be observed in the hospital for at least 48 hours (no early discharge). If only one dose of maternal antibiotics was given before delivery, infants should have a limited evaluation -- complete blood count and differential, and blood culture -- and at least 48 hours of observation before hospital discharge.

Approximately 80 percent of GBS cases occur within the first eight days of life, and these are defined as early-onset infection. In the remaining cases, the disease becomes apparent within the first month and these are defined as late-onset. About 300 to 350 babies die each year in the U.S. as a direct result of group B beta strep infection.

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