Prevent Group B Strep

Antibiotic Regimen

Photo: AntibioticAnswer questions about the patient (such as drug allergies)
to see recommended agent and dosage.
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Prevent Group B Strep

Antibiotic Regimen

Photo: AntibioticAnswer questions about the patient (such as drug allergies)
to see recommended agent and dosage.
Begin

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Prevent Group B Strep

Terms of use

The User acknowledges and agrees that this tool will be used only as a reference aid, and that the information contained in the product is not intended to be (nor should it be used as) a substitute for the exercise of professional judgment.

In view of the possibility of human error or changes in medical science, the User should confirm the information in the product conforms to the current version of the CDC GBS guidelines by checking for guideline updates. This product is provided without warranties of any kind, express or implied, and the authors disclaim any liability, loss, or damage caused by it or its content.

By indicating ‘I agree’ below, you have indicated your acceptance of these terms.

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Prevent Group B Strep

Antibiotic Regimen Choices

Is Patient allergic to penicillin?
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Prevent Group B Strep

Antibiotic Regimen Choices

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Does patient have a history of any of the following after receiving penicillin or a cephalosporin?
  • Anaphylaxis
  • Angioedema
  • Respiratory distress
  • Urticaria
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Prevent Group B Strep

Antibiotic Regimen Choices

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Is the isolate susceptible to clindamycin and erythromycin?
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Erythromycin is no longer an acceptable alternative for intrapartum GBS prophylaxis. Clindamycin and erythromycin susceptibility testing should be performed on prenatal GBS isolates from penicillin-allergic women at high risk for anaphylaxis. If no susceptibility testing is performed, or the results are not available at the time of labor, vancomycin is the preferred agent for GBS intrapartum prophylaxis for penicillin-allergic women at high risk for anaphylaxis.

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Recommended GBS
Prophylaxis Regimen

Penicillin G, 5 million units IV initial dose, then 2.5-3.0 million units every 4 hours until delivery.
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Doses ranging from 2.5 to 3.0 million units are acceptable for the doses administered every 4 hours following the initial dose. The choice within that range should be guided by which formulations of penicillin G are readily available to reduce the need for pharmacies to specially prepare doses.

OR
Ampicillin 2 g IV initial dose, then 1 g IV every 4 hours until delivery

Broader spectrum agents including an agent active against GBS might be necessary for treatment of chorioamnionitis.
Antibiotics given for latency in the setting of pPROM that include ampicillin 2g intravenously (IV) once, followed by 1g IV every 6 hours for at least 48 hours are adequate for GBS prophylaxis. If other regimens are used GBS prophylaxis should be initiated in addition.
Cefazolin 2 g IV initial dose, then 1 g IV every 8 hours until delivery
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Penicillin-allergic women who do not have a history of anaphylaxis, angioedema, respiratory distress, or urticaria following administration of a penicillin or a cephalosporin should receive cefazolin for GBS intrapartum prophylaxis.

Broader spectrum agents including an agent active against GBS might be necessary for treatment of chorioamnionitis.
Vancomycin 1 g IV every 12 hours until delivery
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If a GBS isolate is susceptible to clindamycin, resistant to erythromycin, and testing for inducible clindamycin resistance has been performed and is negative (no inducible resistance), then clindamycin can be used for GBS prophylaxis instead of Vancomycin. However, if no testing for inducible resistance to clindamycin was performed for an isolate susceptible to clindamycin and resistant to erythromycin, or inducible resistance was present, then Vancomycin is the recommended antibiotic choice.

Broader spectrum agents including an agent active against GBS might be necessary for treatment of chorioamnionitis.
Clindamycin 900 mg IV every 8 hours until delivery
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Resistance to erythromycin is often but not always associated with clindamycin resistance. If an isolate is resistant to erythromycin, it might have inducible resistance to clindamycin, even if it appears susceptible to clindamycin. If a GBS isolate is susceptible to clindamycin, resistant to erythromycin, and testing for inducible clindamycin resistance has been performed and is negative (no inducible resistance), then clindamycin can be used for GBS intrapartum prophylaxis instead of Vancomycin.

Broader spectrum agents including an agent active against GBS might be necessary for treatment of chorioamnionitis.
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