Variations Seen in Group B Strep Testing, Prophylaxis By Obstetricians
(HealthDay News) — Almost all obstetricians collect group B streptococcus screening samples, but practice patterns vary, according to research published in the August issue of the American Journal of Obstetrics & Gynecology.
Rodney K. Edwards, MD, from the University of Alabama at Birmingham, and colleagues mailed a survey to 546 members of the American College of Obstetricians and Gynecologists to examine attitudes and practice patterns related to group B streptococcal colonization.
The researchers found that 97% of the 206 respondents collected screening samples at 35–37 weeks' gestational age. The sites used to collect samples varied: 62% included lower vagina and rectum; 26% lower vagina and perianal skin, but not rectum; and 5% did not include perianal skin or rectum. For intrapartum antibiotic prophylaxis, first-line agents were penicillin, ampicillin, and cefazolin (71, 27, and 2%, respectively). Patients with a non-anaphylactic penicillin allergy received cefazolin, clindamycin, vancomycin, and erythromycin (51, 36, 8, and 5%, respectively). For patients undergoing labor induction starting with a cervical ripening agent, less than 40% and 15% gave the first dose before or at agent administration or when the patient reached active labor, respectively.
"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," the authors write.