MANAGEMENT OF GROUP B STREPTOCOCCAL INFECTION

GROUP B STREPTOCOCCAL INFECTION (See Table)

The American Academy of Pediatrics published "Guidelines for Prevention of Group B Streptococcal Infection by Chemoprophylaxis" in November 1992 (Pediatrics Vol. 90 , Nov. 1992, pp. 775-778). Included in this statement were recommendations for management of infants whose mothers received chemoprophylaxis and recommendations for prevention of early-onset neonatal GBS infection. Urine GBS antigen tests result in a false-positive rate of 5%-12% and, therefore, are not useful screening tests in determining who should be treated. Note that these recommendations are only for certain specific circumstances. Attendings should still be consulted regarding who to treat.

MATERNAL STATUS	INFANT STATUS	MANAGEMENT
GBS colonized mother who did not receive chemoprophylaxix	Preterm and asymptomatic	Candidate for empiric antibiotics
GBS colonized mother who did receive intrapartum chemoprophylaxis	Preterm and asymptomatic Any gestational age and symptomatic Term and asymptomatic, mother treated >4h prior to delivery (with appropriate antibiotics)	Candidate for empiric antibiotics  Evaluate for GBS or other early onset infection. Treat with broad spectrum drugs awaiting culture results. No treatment required

• Recommendations regarding treating infants whose mothers received intrapartum chemoprophylaxis are empiric, since at this time, no studies have publishesed regarding their management.

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