Materiały źródłowe

• #1 Group B strep disease – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/group-b-strep/diagnosis-treatment/drc-20351735

  If your baby tests positive for group B strep, the baby receives IV antibiotics through a vein. Depending on your baby’s condition, the baby might need IV fluids, oxygen or other medicines. […] Antibiotics can treat group B strep infection in adults. The choice of antibiotic depends on the location and extent of the infection. It also depends on your specific circumstances. […] If you’re pregnant and you have medical problems because of group B strep, you’ll likely receive antibiotics by mouth. Most often, you’ll be given penicillin, amoxicillin (Amoxil, Larotid) or cephalexin. All are considered safe to take during pregnancy.

• #2 Streptococcus Group B – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553143/

  Group B streptococcus (GBS) commonly appears in up to 35% of healthy women’s reproductive or gastrointestinal tracts. […] Thus, it is essential to screen and understand the clinical presentations and treatments for GBS infections. This activity reviews the healthcare team’s role in the background, presentation, prevention, evaluation, and treatment of Group B streptococcus infections. […] Review the management options available for group B streptococcus infections. […] The initial therapy for suspected neonatal sepsis is ampicillin and an aminoglycoside, typically gentamicin. Both ampicillin and gentamicin have activity against GBS, which is the most common cause of neonatal sepsis. […] Following confirmation of GBS as the causative pathogen, sterility of the bloodstream and cerebrospinal fluid (CSF) are documented, and clinical improvement is observed; penicillin G alone should be used to complete therapy.

• #3 Group B Streptococcus Disease: AAP Updates Guidelines for the Management of At-Risk Infants | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0315/p378.html

  Intrapartum antibiotic prophylaxis prevents newborn GBS through two mechanisms. Maternal antibiotic treatment temporarily decreases vaginal GBS colonization, preventing newborn surface and mucous membrane colonization during birth. Newborn bloodstream antibiotic levels also exceed the minimum inhibitory concentration for GBS. […] Intrapartum antibiotic prophylaxis should be given to all women at delivery who have positive antenatal vaginalrectal cultures for GBS colonization. […] Early-onset GBS antibiotic prophylaxis is effective within two to four hours of administration and penicillin G and ampicillin continue to be recommended for intrapartum antibiotic prophylaxis. […] For women allergic to penicillin who are at high risk of anaphylaxis, clindamycin should be administered to those colonized with GBS that is known to be susceptible to clindamycin.

• #4 Prevention of Group B Streptococcal Early-Onset Disease in Newborns | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/02/prevention-of-group-b-streptococcal-early-onset-disease-in-newborns

  Targeted intravenous intrapartum antibiotic prophylaxis has demonstrated efficacy for prevention of GBS early-onset disease (EOD) in neonates born to women with positive antepartum GBS cultures and women who have other risk factors for intrapartum GBS colonization. […] Regardless of planned mode of birth, all pregnant women should undergo antepartum screening for GBS at 36 0/737 6/7 weeks of gestation, unless intrapartum antibiotic prophylaxis for GBS is indicated because of GBS bacteriuria during the pregnancy or because of a history of a previous GBS-infected newborn. […] If the prenatal GBS culture result is unknown when labor starts, intrapartum antibiotic prophylaxis is indicated for women who have risk factors for GBS EOD. […] Intravenous penicillin remains the agent of choice for intrapartum prophylaxis, with intravenous ampicillin as an acceptable alternative.

• #5 Group B Streptococcus and Pregnancy | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/22444

  GBS colonization in pregnancy is primarily treated with IAP to decrease the transmission of GBS and the incidence of neonatal sepsis by reducing the maternal GBS burden within the genitourinary tract and eliminating GBS bacteria in the fetus. […] However, IAP guidelines are not consistently implemented; therefore, GBS remains a leading cause of early-onset neonatal sepsis in the United States. Furthermore, up to 40% of individuals who test positive for GBS during prenatal care may test negative at delivery, leading to significant overtreatment and increasing antibiotic resistance. Consequently, studies continue to investigate alternative management approaches for GBS in pregnancy, including probiotic interventions and maternal vaccines. […] IAP is recommended to prevent neonatal GBS-EOD in women with identified GBS colonization or with risk factors for GBS colonization. […] Indications for intrapartum GBS prophylaxis include: GBS colonization identified by antenatal culture, GBS bacteriuria detected during pregnancy, history of a previous infant with GBS disease, unknown GBS status and preterm labor or preterm premature rupture of membranes (37 0/7 weeks), unknown GBS status with any of the following risk factors at 37 0/7 weeks of gestation: maternal fever 100.4 F (38 C), prolonged rupture of membranes (18 hours), positive point-of-care NAAT for GBS, history of GBS colonization in a previous pregnancy, negative intrapartum NAAT, but risk factors develop during labor, such as maternal fever and prolonged rupture of membranes, suspected intra-amniotic infection (broad-spectrum antibiotics, including GBS coverage, should be given).

• #6 Group B streptococcus (GBS) – screening and management | Safer Care Victoria

  https://www.safercare.vic.gov.au/best-practice-improvement/clinical-guidance/maternity/group-b-streptococcus-gbs-screening-and-management

  The decision to give antibiotic treatment in labour can be determined through: consistent identification of clinical risk factors during pregnancy and labour or taking a combined vaginal-rectal swab at 35-37 weeks gestation. […] If any of the above risk factors are identified, IAP is recommended once active labour is identified. […] Aim for ≥4 hours of IAP coverage prior to birth. […] Antibiotic prophylaxis is not recommended prior to the onset of labour. […] Recommend IAP to women with identified risk factors when active labour is identified. […] Adequate prophylaxis is considered to be commenced at least four hours prior to birth. […] Benzylpenicillin is the antibiotic of choice – IV penicillin and ampicillin are equally effective against GBS, but penicillin is preferable due to its narrower spectrum of activity. […] Treat all unwell babies for suspected sepsis, irrespective of maternal GBS status or adequate IAP.

• #7 Prevention of Perinatal Group B Streptococcal Disease: Updated CDC Guideline | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0701/p59.html

  Group B streptococcus is the leading cause of early-onset neonatal sepsis in the United States. Universal screening is recommended for pregnant women at 35 to 37 weeks gestation. […] The new guideline presents separate algorithms for management of preterm labor and preterm premature rupture of membranes, rather than a single algorithm for both conditions. […] For those at serious risk of anaphylaxis, clindamycin is recommended if the organism is susceptible, and vancomycin is recommended if there is clindamycin resistance or if susceptibility is unknown. […] The recommended approach for antibiotic dosing is shown in […] Penicillin is the recommended antibiotic for intrapartum chemoprophylaxis of group B streptococcal disease; ampicillin is an acceptable alternative. […] The new guideline clarifies that women who are allergic to penicillin are at risk of anaphylaxis if they have a history of anaphylaxis, angioedema, respiratory distress, or urticaria after administration of penicillin or a cephalosporin.

• #8 Group B Streptococcus | Diagnostic Laboratory Services, Inc.

  https://dlslab.com/physicians/group-b-streptococcus/

  For intrapartum hemoprophylaxis, intravenous (IV) penicillin G (5 million units initially and then 2.5 million units every 4 hours) should be administered until delivery. […] IV Ampicillin (2 grams initially and then 1 gram every 4 hours until delivery) is an acceptable alternative to penicillin G. […] Clindamycin or erythromycin may be used for women allergic to penicillin, although the efficacy of these drugs for GBS disease prevention has not been measured in controlled trials. […] Women with clinical diagnosis of amnionitis who are receiving other treatment such as ampicillin or clindamycin do not need penicillin G added to the regimen.

• #9 Prevention of Group B Streptococcal Early-Onset Disease in Newborns | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/02/prevention-of-group-b-streptococcal-early-onset-disease-in-newborns

  Targeted intravenous intrapartum antibiotic prophylaxis has demonstrated efficacy for prevention of GBS early-onset disease (EOD) in neonates born to women with positive antepartum GBS cultures and women who have other risk factors for intrapartum GBS colonization. […] Regardless of planned mode of birth, all pregnant women should undergo antepartum screening for GBS at 36 0/737 6/7 weeks of gestation, unless intrapartum antibiotic prophylaxis for GBS is indicated because of GBS bacteriuria during the pregnancy or because of a history of a previous GBS-infected newborn. […] If the prenatal GBS culture result is unknown when labor starts, intrapartum antibiotic prophylaxis is indicated for women who have risk factors for GBS EOD. […] Intravenous penicillin remains the agent of choice for intrapartum prophylaxis, with intravenous ampicillin as an acceptable alternative.

• #10 Prevention of Group B Streptococcal Early-Onset Disease in Newborns | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/02/prevention-of-group-b-streptococcal-early-onset-disease-in-newborns

  ABSTRACT: Group B streptococcus (GBS) is the leading cause of newborn infection. […] The key obstetric measures necessary for effective prevention of GBS EOD continue to include universal prenatal screening by vaginalrectal culture, correct specimen collection and processing, appropriate implementation of intrapartum antibiotic prophylaxis, and coordination with pediatric care providers. […] The American College of Obstetricians and Gynecologists now recommends performing universal GBS screening between 36 0/7 and 37 6/7 weeks of gestation. […] All women whose vaginalrectal cultures at 36 0/737 6/7 weeks of gestation are positive for GBS should receive appropriate intrapartum antibiotic prophylaxis unless a prelabor cesarean birth is performed in the setting of intact membranes. […] Although a shorter duration of recommended intrapartum antibiotics is less effective than 4 or more hours of prophylaxis, 2 hours of antibiotic exposure has been shown to reduce GBS vaginal colony counts and decrease the frequency of a clinical neonatal sepsis diagnosis.

• #11 Prevention of Perinatal Group B Streptococcal Disease: Updated CDC Guideline | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0701/p59.html

  Clindamycin (900 mg intravenously every eight hours until delivery) is the drug of choice if the GBS isolate is susceptible to clindamycin and erythromycin, and if there is no inducible clindamycin resistance. […] The new guideline defines inadequate intrapartum chemoprophylaxis as failure to receive at least four hours of intravenous penicillin, ampicillin, or cefazolin before delivery.

• #12 Prevention of Group B Streptococcal Early-Onset Disease in Newborns | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/02/prevention-of-group-b-streptococcal-early-onset-disease-in-newborns

  For women with a high risk of anaphylaxis, clindamycin is the recommended alternative to penicillin only if the GBS isolate is known to be susceptible to clindamycin. […] Intravenous vancomycin remains the only pharmacokinetically and microbiologically validated option for intrapartum antibiotic prophylaxis in women who report a high-risk penicillin allergy and whose GBS isolate is not susceptible to clindamycin. […] Obstetric interventions, when necessary, should not be delayed solely to provide 4 hours of antibiotic administration before birth.

• #13 Streptococcus Group B – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553143/

  For women with severe penicillin allergy (anaphylaxis, angioedema, respiratory distress, or urticaria), susceptibility testing should be performed, and clindamycin (900 mg every 8 hours until delivery) or vancomycin (1 g every 12 hours until delivery) can be given to based on susceptibility patterns of the isolated GBS organism.

• #14 Prevention of Perinatal Group B Streptococcal Disease: Updated CDC Guideline | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0701/p59.html

  Group B streptococcus is the leading cause of early-onset neonatal sepsis in the United States. Universal screening is recommended for pregnant women at 35 to 37 weeks gestation. […] The new guideline presents separate algorithms for management of preterm labor and preterm premature rupture of membranes, rather than a single algorithm for both conditions. […] For those at serious risk of anaphylaxis, clindamycin is recommended if the organism is susceptible, and vancomycin is recommended if there is clindamycin resistance or if susceptibility is unknown. […] The recommended approach for antibiotic dosing is shown in […] Penicillin is the recommended antibiotic for intrapartum chemoprophylaxis of group B streptococcal disease; ampicillin is an acceptable alternative. […] The new guideline clarifies that women who are allergic to penicillin are at risk of anaphylaxis if they have a history of anaphylaxis, angioedema, respiratory distress, or urticaria after administration of penicillin or a cephalosporin.

• #15 Group B Streptococcus (GBS) Infections Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/229091-treatment

  Group B streptococci are likely to be sensitive to penicillin and ampicillin. However, resistance to penicillin (and beta-lactams in general) has been increasing, as documented in studies done in the United States, Hong Kong, and Japan. […] Therefore, sensitivity testing should be done before these agents are used. Oral clindamycin remains an excellent agent for use after a course of parenteral therapy for bone, soft-tissue, and lung infections, if the isolate is susceptible. […] Because of possible resistance to clindamycin, vancomycin remains the initial treatment of choice for GBS infection in patients who are allergic to penicillin. […] In general, if ampicillin, penicillin, vancomycin, or ceftriaxone cannot be used, consultation with an infectious diseases specialist is strongly recommended.

• #16 Group B Strep (GBS) in Pregnancy | ABC Law Centers: Birth Injury Lawyers

  https://www.abclawcenters.com/practice-areas/maternal-infections/group-b-strep/

  When a woman tests positive for GBS, the physician must devise a plan to minimize the baby’s exposure to the infection during the birthing process. In order to prevent GBS in babies, antibiotics must be administered to the mother during labor. In fact, antibiotic treatment is recommended for: […] Penicillin is the preferred medication for intrapartum antibiotic treatment, and ampicillin is an acceptable alternative. […] While maternal antibiotics and other preventative measures may reduce a baby’s chance of contracting GBS, all newborns born to mothers who are GBS carriers should be carefully monitored to identify the earliest manifestations of the disease. GBS in neonates is treated via a combination of antimicrobial therapy and supportive care. […] When the signs and symptoms are first noticed in an infant, but an official GBS diagnosis has not yet been made, doctors must administer what is known as “empiric” antibiotic therapy.

• #17 Streptococcus Group B – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553143/

  Group B streptococcus (GBS) commonly appears in up to 35% of healthy women’s reproductive or gastrointestinal tracts. […] Thus, it is essential to screen and understand the clinical presentations and treatments for GBS infections. This activity reviews the healthcare team’s role in the background, presentation, prevention, evaluation, and treatment of Group B streptococcus infections. […] Review the management options available for group B streptococcus infections. […] The initial therapy for suspected neonatal sepsis is ampicillin and an aminoglycoside, typically gentamicin. Both ampicillin and gentamicin have activity against GBS, which is the most common cause of neonatal sepsis. […] Following confirmation of GBS as the causative pathogen, sterility of the bloodstream and cerebrospinal fluid (CSF) are documented, and clinical improvement is observed; penicillin G alone should be used to complete therapy.

• #18 Group B Streptococcus Disease: AAP Updates Guidelines for the Management of At-Risk Infants | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0315/p378.html

  If early-onset GBS disease is highly suspected, a lumbar puncture and analysis of cerebrospinal fluid should be performed. […] Ampicillin with an aminoglycoside is recommended for infants up to seven days of age. […] Without signs of meningitis or severe illness, ampicillin and ceftazidime (Fortaz) are recommended for infants eight to 28 days of age and ceftriaxone (Rocephin) is recommended for infants 29 to 90 days of age. […] Persistent mucosal colonization and poor neonatal antibody responses to the first infection can lead to recurrent GBS infection. Preventing recurrence of GBS disease is not possible, and parents should be counseled about the possibility of recurrence after the initial treatment for early- and late-onset GBS disease.

• #19 Streptococcus Group B – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553143/

  Group B streptococcus (GBS) commonly appears in up to 35% of healthy women’s reproductive or gastrointestinal tracts. […] Thus, it is essential to screen and understand the clinical presentations and treatments for GBS infections. This activity reviews the healthcare team’s role in the background, presentation, prevention, evaluation, and treatment of Group B streptococcus infections. […] Review the management options available for group B streptococcus infections. […] The initial therapy for suspected neonatal sepsis is ampicillin and an aminoglycoside, typically gentamicin. Both ampicillin and gentamicin have activity against GBS, which is the most common cause of neonatal sepsis. […] Following confirmation of GBS as the causative pathogen, sterility of the bloodstream and cerebrospinal fluid (CSF) are documented, and clinical improvement is observed; penicillin G alone should be used to complete therapy.

• #20 Group B Strep (GBS) in Pregnancy | ABC Law Centers: Birth Injury Lawyers

  https://www.abclawcenters.com/practice-areas/maternal-infections/group-b-strep/

  Once a definitive GBS diagnosis has been made, physicians must administer penicillin alone to fight GBS infection. […] Alongside antimicrobial therapy, the following measures may be taken to help in the treatment of GBS: Management of seizures, Treatment of anemia, Ventilatory support, Treatment of shock, Fluid and electrolyte maintenance. […] It is negligence when a mother and baby are not properly tested for GBS, and when standards for treating the condition are not followed.

• #21 Group B Streptococcus (Streptococcus agalactiae)

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6432937/

  In neonates with presumptive EOD, empiric therapy with ampicillin combined with an aminoglycoside is the standard of care. […] Once GBS is isolated, penicillin G monotherapy is recommended for treatment of invasive GBS infection in infants. Recommended dosing of penicillin G for infants up to 7 days of age is 250,000 to 450,000 units/kg/day and 450,000 to 500,000 units/kg/day for infants older than 7 days.

• #22 Streptococcus Group B – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553143/

  Infants with GBS meningitis should undergo a second lumbar puncture 1 to 2 days into therapy to document CSF sterility. […] If CSF culture is negative, treatment therapy can be completed using penicillin G alone for a minimum of 14 days. […] The treatment duration for patients with septic arthritis, osteomyelitis, or endocarditis appears in the table. […] Intrapartum antibiotic prophylaxis (IAP) is indicated for all mothers with a positive GBS screening culture routinely obtained at 35 to 37 weeks gestation. […] Prophylaxis with a beta-lactam antibiotic (preferably penicillin) given four or more hours before delivery is highly effective for early-onset disease prevention. […] The definition of adequate IAP is administering penicillin, ampicillin, or cefazolin at least 4 hours before delivery.

• #23 Group B Streptococcus (Streptococcus agalactiae)

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6432937/

  Intrapartum antibiotic prophylaxis has reduced the incidence of early-onset neonatal disease without a notable impact on the incidence of late-onset neonatal disease. […] Penicillin G remains the mainstay of therapy, although reduced penicillin susceptibility has been observed in select isolates. […] The development and implementation of strategies to identify hosts, treat judiciously with antimicrobials with the narrowest spectra, and prevent invasive disease, with vaccines, are essential to reduce the burden of group B Streptococcus disease. […] Penicillin G is the first-line treatment for invasive GBS disease in adults. […] The duration of therapy depends on the clinical presentation. Ten days of therapy is generally acceptable for bacteremia, pneumonia, pyelonephritis, and skin/soft tissue infections.

• #24 Group A and B Streptococcus: symptoms, treatment, prevention – Institut Pasteur

  https://www.pasteur.fr/en/medical-center/disease-sheets/group-and-b-streptococcus

  Intrapartum antibiotic prophylaxis is based on a -lactam (penicillin or amoxicillin) or a macrolide in the event of an allergy. […] In newborns, treatment mainly involves the intravenous administration of -lactam (amoxicillin), possibly in conjunction with another antibiotic (gentamicin) for the first 48 hours, over a period of 10 days to 3 weeks depending on the site of infection (meningitis, arthritis, etc.). […] There is no vaccine for group B Streptococcus infections.

• #25 Group B strep disease – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/group-b-strep/diagnosis-treatment/drc-20351735

  If your baby tests positive for group B strep, the baby receives IV antibiotics through a vein. Depending on your baby’s condition, the baby might need IV fluids, oxygen or other medicines. […] Antibiotics can treat group B strep infection in adults. The choice of antibiotic depends on the location and extent of the infection. It also depends on your specific circumstances. […] If you’re pregnant and you have medical problems because of group B strep, you’ll likely receive antibiotics by mouth. Most often, you’ll be given penicillin, amoxicillin (Amoxil, Larotid) or cephalexin. All are considered safe to take during pregnancy.

• #26 Pharmacy Clinical Pearl of the Day: Group B Streptococcus

  https://www.pharmacytimes.com/view/pharmacy-clinical-pearl-of-the-day-group-b-streptococcus

  Group B strep can also cause dangerous infections in adults with certain chronic medical conditions, such as diabetes or liver disease. Older adults are at increased risk of illness due to group B strep, too. […] If you’re pregnant, get a group B strep screening test during the third trimester. If you have group B strep, antibiotic treatment during labor can protect the baby. […] Treatment for infants may include intravenous antibiotics and fluids. Treatment for adults may include oral antibiotics such as cephalexin (Keflex), penicillin, or amoxicillin.

• #27 Group B strep disease – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/group-b-strep/diagnosis-treatment/drc-20351735

  If your baby tests positive for group B strep, the baby receives IV antibiotics through a vein. Depending on your baby’s condition, the baby might need IV fluids, oxygen or other medicines. […] Antibiotics can treat group B strep infection in adults. The choice of antibiotic depends on the location and extent of the infection. It also depends on your specific circumstances. […] If you’re pregnant and you have medical problems because of group B strep, you’ll likely receive antibiotics by mouth. Most often, you’ll be given penicillin, amoxicillin (Amoxil, Larotid) or cephalexin. All are considered safe to take during pregnancy.

• #28 Group B Streptococcus (GBS) Infections Medication: Antibiotics

  https://emedicine.medscape.com/article/229091-medication

  The goals of pharmacotherapy are to reduce morbidity and to prevent complications. […] Empiric antimicrobial therapy must be comprehensive and should cover all likely pathogens in the context of the clinical setting. Therapy should begin immediately after blood cultures are obtained. […] Penicillin remains the drug of choice for group B streptococcal infection. […] Ampicillin remains a drug of choice for group B streptococcal infection. […] Ceftriaxone is alternative therapy to penicillin for group B streptococcal infection. Ceftriaxone would be effective for meningitis. […] Cefazolin is alternative therapy to penicillin for group B streptococcal infection. Cefazolin would not be effective for meningitis. […] Vancomycin is the initial treatment of choice for group B streptococcal infection in the penicillin-allergic individual. […] Not for use as initial therapy because a small percent of group B streptococci will be resistant to clindamycin. […] Aminoglycosides show synergy when used with penicillin for group B streptococcus.

• #29 Group B Streptococcus (GBS) in Adults: Commonly Asked Questions – MN Dept. of Health

  https://www.health.state.mn.us/diseases/strep/gbs/gbsadults.html

  GBS infections are usually treated with penicillin. […] Sometimes other types of antibiotics are used. […] Soft tissue and bone infections may require surgery to treat. […] Treatment often depends on where the bacteria in found in the body.

• #30 Group B Streptococcus (GBS) in pregnancy and newborn babies | RCOG

  https://www.rcog.org.uk/for-the-public/browse-our-patient-information/group-b-streptococcus-gbs-in-pregnancy-and-newborn-babies/

  Group B Streptococcus (GBS) is one of the many bacteria that normally live in our bodies and which usually cause no harm. […] If GBS is found in your urine, vagina or rectum (bowel) during your current pregnancy, or if you have previously had a baby affected by GBS infection, you should be offered antibiotics in labour to reduce the small risk of this infection to your baby. […] If your newborn baby develops signs of GBS infection, they should be treated with antibiotics straight away. […] A urine infection caused by GBS should be treated with antibiotic tablets straight away and you should also be offered antibiotics through a drip during labour. […] You should be offered antibiotics through a drip during labour if you have had a GBS-positive swab or urine test from an NHS or other accredited laboratory.

• #31 Group B strep infection | March of Dimes

  https://www.marchofdimes.org/find-support/topics/planning-baby/group-b-strep-infection

  It’s not helpful to take oral antibiotics before labor to treat GBS. […] Babies infected with early-onset GBS or late-onset GBS are treated with antibiotics through an IV, and are kept in the hospital until the cultures are negative. […] If you’re treated for GBS during labor and birth, you probably won’t get a uterine infection after your baby is born. […] If you have a UTI caused by GBS, your provider gives you antibiotics to take by mouth during pregnancy.

• #32

  https://www.who.int/teams/immunization-vaccines-and-biologicals/diseases/group-b-streptococcus-(gbs)

  Group B Streptococcus (GBS) is a leading cause of neonatal and infant sepsis and meningitis globally. […] Administration of intrapartum antibiotic prophylaxis (IAP) to pregnant women with GBS colonization can substantially reduce the incidence of early-onset GBS disease, but IAP does not prevent late-onset GBS disease, which in most cases are transmitted postnatally. […] An effective maternal GBS vaccine targeting pregnant women offers the potential to protect infants against both early- and late-onset GBS disease through transplacental transfer of maternal antibodies, and reduce disease burden worldwide. […] The development of Group B Streptococcus (GBS) vaccines for maternal immunization has been identified by the Product Development for Vaccines Advisory Committee (PDVAC) as a priority, because of the major public health burden posed by GBS in LMIC.

• #33 Group B strep disease – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/group-b-strep/symptoms-causes/syc-20351729

  If you’re pregnant, get a group B strep screening test during your third trimester. If you have this type of bacteria in your body, medicines called antibiotics given to you during labor can protect your baby. […] Medicine can prevent group B bacteria from spreading to your baby during labor or delivery. An antibiotic through a needle in a vein, also called an IV, is given to you when labor begins. The antibiotic is usually penicillin or a related medicine. […] If you’re allergic to penicillin or related medicines, you might receive another antibiotic such as clindamycin or vancomycin instead. But it’s not clear how well these other antibiotics work. […] Antibiotic treatment during labor also is recommended if you: Have a urinary tract infection. Delivered a previous baby with group B strep disease. Get a fever during labor. Haven’t delivered your baby within 18 hours of your water breaking. Go into labor before 37 weeks and haven’t been tested for group B strep. […] Although it’s not available yet, researchers are working on a group B strep vaccine. It could help prevent group B strep infections in the future.

• #34

  https://www.who.int/teams/immunization-vaccines-and-biologicals/diseases/group-b-streptococcus-(gbs)

  The strategic goal for GBS vaccines is to develop and license safe, effective and affordable GBS vaccines for maternal immunization during pregnancy to prevent GBS-related stillbirth and invasive GBS disease in neonates and young infants, appropriate for use in high-, middle- and low-income countries. […] Efficacy studies for GBS vaccine will require a large number of participants, therefore initial vaccine licensure based on immunological correlates of protection (CoP) should be explored, followed by post licensure studies to assess effectiveness and to evaluate the reduction in disease burden. […] Group B Streptococcus infection causes an estimated 150,000 preventable stillbirths and infant deaths every year.

• #35 Natural and Integrative Treatments for Group B Strep in Women

  https://naturemed.org/natural-and-integrative-treatments-for-group-b-strep-in-women/

  Intravenous antibiotics are the first course of antibiotic treatment, though naturopathic doctors may offer other therapies to support the body. […] Probiotics, including specialized Bifidobacterium and Lactobacillus strains, can help restore the balance of gut bacteria and may allow the doctor to reduce the required dosage of antibiotics. […] Compounds isolated from raw garlic may have antimicrobial properties for GBS (however, do not self-administer raw garlic or other forms of garlic as a treatment as further research needs to be done to determine the most appropriate method of administration to effectively prevent the transmission of GBS to a newborn). […] By implementing these preventive measures screening, education, and hygiene practices the incidence of illness and complications from a Group B Strep infection can be significantly reduced among women of childbearing age, ensuring the health and well-being of pregnant mothers and their babies.

• #36 Group B Streptococcus and Pregnancy | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/22444

  ACOG recommends penicillin as the first-line antibiotic for GBS prophylaxis due to its narrow antimicrobial activity, which decreases the risk of resulting antibiotic resistance. […] A loading dose of 5 million units followed by 2.5 to 3 million units intravenously (IV) every 4 hours until delivery should be used to attain the serum drug levels needed to inhibit GBS bacteria in the fetus. […] For women with penicillin allergies, the choice of IAP antibiotic depends on the allergy history and, if available, clindamycin susceptibility results from GBS cultures. […] Due to known adverse effects of IAP, including allergic reactions, neonatal thrush, and antibiotic resistance, other therapeutic avenues have been researched to treat GBS colonization. […] Maternal GBS vaccines have shown promise in preventing GBS-EOD; however, further studies are required to provide evidence of the effectiveness and full scope of risks with these vaccines before being utilized for this indication. In addition, maternal ingestion of probiotics during pregnancy was ineffective in eliminating maternal GBS colonization; however, the authors of this study reported that their findings showed a potential reduction of persistent GBS colonization, requiring further investigation.

• #37 Prevention of Group B Streptococcal Early-Onset Disease in Newborns | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/02/prevention-of-group-b-streptococcal-early-onset-disease-in-newborns

  ABSTRACT: Group B streptococcus (GBS) is the leading cause of newborn infection. […] The key obstetric measures necessary for effective prevention of GBS EOD continue to include universal prenatal screening by vaginalrectal culture, correct specimen collection and processing, appropriate implementation of intrapartum antibiotic prophylaxis, and coordination with pediatric care providers. […] The American College of Obstetricians and Gynecologists now recommends performing universal GBS screening between 36 0/7 and 37 6/7 weeks of gestation. […] All women whose vaginalrectal cultures at 36 0/737 6/7 weeks of gestation are positive for GBS should receive appropriate intrapartum antibiotic prophylaxis unless a prelabor cesarean birth is performed in the setting of intact membranes. […] Although a shorter duration of recommended intrapartum antibiotics is less effective than 4 or more hours of prophylaxis, 2 hours of antibiotic exposure has been shown to reduce GBS vaginal colony counts and decrease the frequency of a clinical neonatal sepsis diagnosis.

• #38 Group B Streptococcus Disease: AAP Updates Guidelines for the Management of At-Risk Infants | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0315/p378.html

  Maternal screening for GBS and intrapartum antibiotics for positive screening are important for reducing early-onset GBS disease risk. […] For well-appearing infants born at 35 weeks’ gestation or later, determining treatment with a risk calculator and clinical monitoring for 36 to 48 hours are alternatives to empiric antibiotics, even with maternal intrapartum fever. […] Infants born before 35 weeks’ gestation because of cervical insufficiency, preterm labor, premature rupture of membranes, intra-amniotic infection, or acute or unexplained nonreassuring fetal status should receive empiric antibiotics because of the high risk of GBS disease. […] Infants born before 35 weeks’ gestation because of other causes should receive empiric antibiotics for insufficient intrapartum antibiotics, maternal intrapartum fever, or newborn signs of illness.

• #39 Evidence on Group B Strep in Pregnancy

  https://evidencebasedbirth.com/groupbstrep/

  If the birthing person with GBS is treated with antibiotics during labor, the risk of their infant developing early GBS disease drops by 80%. So, for example, the risk could drop from 1% down to 0.2%. […] In summary, although these studies had limitations (not uncommon for research published before 1996), there is also some valid information that we can use. […] Although it would be best if we had modern, larger, randomized, controlled trials on antibiotics for Group B Strep, such trials will not be available given that antibiotics are already in routine use, and it could be considered unethical to withhold antibiotics. […] In 1973, a researcher proposed giving pregnant people penicillin to prevent early GBS disease in infants. […] The results showed that when participants with GBS had antibiotics during labor, the risk of their infants developing early GBS disease dropped by 83%.

• #40

  https://www.healthychildren.org/English/news/Pages/AAP-Updates-Guidance-on-Infants-With-Group-B-Strep-Disease.aspx

  Both groups support universal maternal screening and when appropriate, antibiotics to prevent transmission of Group B streptococcal bacteria from mother to infant before or during delivery. […] Administering antibiotic during childbirth, when indicated and as recommended by the American College of Obstetricians and Gynecologists, to protect the newborn from transmission of Group B streptococcal bacteria. […] Updated dosing recommendations for treatment of neonatal and infant Group B streptococcal disease. The preferred antibiotic for confirmed GBS disease in infants is penicillin G, followed by ampicillin. […] We hope to identify more ways to prevent these infections, such as a vaccine that could be used worldwide, Dr. Puopolo said. These guidelines are the most effective tool we have right now to protect infants and save lives.

• #41

  https://www.healthychildren.org/English/news/Pages/AAP-Updates-Guidance-on-Infants-With-Group-B-Strep-Disease.aspx

  Pediatricians update neonatal recommendations that, together with revised maternal guidelines by the American College of Obstetricians and Gynecologists, replace the CDC 2010 Perinatal GBS Prevention guidelines. […] The American Academy of Pediatrics, issuing a clinical report on managing infants at risk for Group B Streptococcal Disease, affirms its support for universal testing of pregnant women so that antibiotic treatment may be provided during delivery to protect the newborn. […] AAP is pleased to support maternal policies and procedures that help safeguard infants from this disease, which can have severe — and sometimes fatal consequences, said the reports lead author, Karen M. Puopolo, MD, PhD, a member of the AAP Committee on Fetus and Newborn. We know that by taking preventive steps during prenatal care, and by treating the mother with antibiotics during labor, we can prevent infection in babies. This is especially important for preterm babies who face higher risks.

• #42 GBS Screening: An update on guidelines and methods

  https://www.contemporaryobgyn.net/view/gbs-screening-update-guidelines-and-methods

  Rapid testing by PCR amplification will be increasingly useful in patients who are late entries to prenatal care or have preterm labor or PPROM and can potentially avoid overuse of neonatal antibiotics and prolonged neonatal hospital stay. […] Wider use of DNA amplification assays may provide a benefit of higher sensitivity and minimize false negatives.

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