Culture-based group B streptococcal screening. Adherence to current guidelines
Pinette, M.G.; Wax, J.R.; Blackstone, J.; Cartin, A.; McCrann, D.J.
Journal of Reproductive Medicine 48(5): 309-312
2003
ISSN/ISBN: 0024-7758 PMID: 12815900 Document Number: 563927
OBJECTIVE: To examine the ability of a universal screening strategy to identify and treat group B Streptococcus-positive women with intrapartum antibiotics. STUDY DESIGN: Charts were reviewed on all patients delivering at gtoreq36 weeks of gestation as to the presence of culture results, whether or not antibiotics were ordered and when they were given relative to the time of delivery. RESULTS: Approximately 95% of patients presenting at gtoreq36 weeks had group B Streptococcus results available. Overall, 84% of culture-positive patients received chemoprophylaxis. Removal of the elective cesareans from the study population increased the percentage of positive patients receiving antibiotics to 94%. Ideal chemoprophylaxis, defined as delivering gtoreq2 hours after receiving the recommended antibiotics, occurred 87% of the time. Failure to order appropriate antibiotics was the most frequent reason for not receiving chemoprophylaxis. CONCLUSION: Successful universal culturing followed by intrapartum chemoprophylaxis can be accomplished in a majority of cases. Failure to treat can occur (6%), and chemoprophylaxis may be less than ideal (13%) due to rapid labor and human error.