Survey of American obstetricians regarding group B streptococcus: opinions and practice patterns.

Abstract

OBJECTIVE:

The objective of the study was to evaluate attitudes and practice patterns of obstetricians related to screening for group B streptococcal colonization and providing intrapartum antibiotic prophylaxis against early-onset neonatal infections with group B streptococcus.

STUDY DESIGN:

We mailed a survey to 546 members of the American College of Obstetricians and Gynecologists, including members of the Collaborative Ambulatory Research Network and non-Collaborative Ambulatory Research Network members. Stratified random selection was used to generate samples from both of these groups.

RESULTS:

The survey response rate was 60% for Collaborative Ambulatory Research Network members and 42% for non-Collaborative Ambulatory Research Network members. Of the 206 respondents who reported providing prenatal care, 97% collect screening samples at 35-37 weeks' gestational age. Anatomic sites used to collect samples were more variable: 62% include lower vagina and rectum, 26% include lower vagina and perianal skin but not rectum, and 5% include neither the perianal skin nor the rectum. First-line agents for intrapartum antibiotic prophylaxis were penicillin (71%), ampicillin (27%), and cefazolin (2%). For patients reporting a nonanaphylactic penicillin allergy, drugs used for intrapartum antibiotic prophylaxis were more varied: cefazolin (51%), clindamycin (36%), vancomycin (8%), and erythromycin (5%). For patients undergoing a labor induction starting with a cervical ripening agent, less than 40% typically give the first dose of intrapartum antibiotic prophylaxis before or at the time of cervical ripening agent administration, and 15% wait until the patient reaches the active phase of labor.

CONCLUSION:

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. New approaches to improve implementation are warranted.

• Authors: Rodney K Edwards, Ying Tang, Greta B Raglan, Jeff M Szychowski, Jay Schulkin, Stephanie J Schrag
• Journal: American journal of obstetrics and gynecology (Am J Obstet Gynecol) Vol. 213 Issue 2 Pg. 229.e1-7 (Aug 2015) ISSN: 1097-6868 [Electronic] United States
• PMID: 25816787 (Publication Type: Journal Article)
• Copyright: Copyright © 2015 Elsevier Inc. All rights reserved.

Chemical References

• Anti-Bacterial Agents
• Penicillins
• Ampicillin
• Cefazolin

Topics

• Adult
• Ampicillin (therapeutic use)
• Anti-Bacterial Agents (therapeutic use)
• Asymptomatic Infections
• Attitude of Health Personnel
• Carrier State (diagnosis, drug therapy)
• Cefazolin (therapeutic use)
• Female
• Humans
• Infant, Newborn
• Infant, Newborn, Diseases (prevention & control)
• Labor, Obstetric
• Male
• Mass Screening
• Middle Aged
• Obstetrics
• Penicillins (therapeutic use)
• Practice Patterns, Physicians'
• Pregnancy
• Streptococcal Infections (diagnosis, prevention & control)
• Streptococcus agalactiae
• United States