Prescrire international
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Prescrire international · Mar 2011
ReviewPreventing neonatal group B streptococcal infection. Intrapartum antibiotic prophylaxis in some high-risk situations.
Group B streptococci (GBS) are the leading cause of life-threatening neonatal bacterial infections in developed countries. The newborn is initially colonised during passage through the birth canal. Maternal vaginal carriage is usually asymptomatic. ⋯ In the United Kingdom, systematic antibiotic therapy is recommended in high-risk situations, without systematic screening for Group B streptococci. In practice, the first priority is to identify situations in which there is a high risk of neonatal GBS infection, and to administer antibiotics during labour, after screening for GBS carriage, if possible. Outside of these situations, the risk of an anaphylactic reaction must be minimised by choosing the prophylactic antibiotic based on maternal allergy history, and by avoiding antibiotic prophylaxis altogether if the mother has a history of anaphylaxis, whatever the cause.