Ampicillin Prevents Intrapartum Transmission of Group B Streptococcus

Yow, Martha D.; Mason, Edward O.; Leeds, Leroy J.; Thompson, Peter; Clark, Dorothy J.; Gardner, Susan E.

doi:10.1001/jama.1979.03290380021019

Cited by 187 publications

(17 citation statements)

References 14 publications

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“…In the 1980s, clinical trials demonstrated that GBS EOD might be prevented by systemic antibiotic prophylaxis given at onset of labor to women colonized by GBS [1,18,[26][27][28]. Since the 1990s, major initiatives have been proposed to prevent neonatal GBS EOD.…”

Section: Introductionmentioning

confidence: 99%

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Renzo

Melin²,

Berardi

et al. 2014

The Journal of Maternal-Fetal & Neonatal Medicine

153

135

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Group B streptococcus (GBS) remains worldwide a leading cause of severe neonatal disease. Since the end of the 1990s, various strategies for prevention of the early onset neonatal disease have been implemented and have evolved. When a universal antenatal GBS screening-based strategy is used to identify women who are given an intrapartum antimicrobial prophylaxis, a substantial reduction of incidence up to 80% has been reported in the USA as in other countries including European countries. However recommendations are still a matter of debate due to challenges and controversies on how best to identify candidates for prophylaxis and to drawbacks of intrapartum administration of antibiotics. In Europe, some countries recommend either antenatal GBS screening or risk-based strategies, or any combination, and others do not have national or any other kind of guidelines for prevention of GBS perinatal disease. Furthermore, accurate population-based data of incidence of GBS neonatal disease are not available in some countries and hamper good effectiveness evaluation of prevention strategies. To facilitate a consensus towards European guidelines for the management of pregnant women in labor and during pregnancy for the prevention of GBS perinatal disease, a conference was organized in 2013 with a group of experts in neonatology, gynecologyobstetrics and clinical microbiology coming from European representative countries. The group reviewed available data, identified areas where results were suboptimal, where revised procedures and new technologies could improve current practices for prevention of perinatal GBS disease. The key decision issued after the conference is to recommend intrapartum antimicrobial prophylaxis based on a universal intrapartum GBS screening strategy using a rapid real time testing.

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Section: Introductionmentioning

confidence: 99%

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Renzo

Melin²,

Berardi

et al. 2014

The Journal of Maternal-Fetal & Neonatal Medicine

153

135

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“…The body of evidence in the literature shows that intrapartum chemoprophylaxis is an effective means of preventing vertical transmission of GBS [4,5] . A number of studies have demonstrated a signifi cant reduction of early-onset neonatal infections by intrapartum chemoprophylaxis with penicillin or ampicillin in patients colonized with GBS [6][7][8][9] . A major worry among the obstetricians concerns administration of beta-lactam antibiotics to women with penicillin allergy.…”

Section: Introductionmentioning

confidence: 99%

Antibiotic Susceptibility Profile of Group B Streptococcus <i>(Streptococcus agalactiae)</i> at the Maternity Hospital, Kuwait

Al‐Sweih

Jamal²,

Kurdia³

et al. 2005

Med Princ Pract

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Objectives: This study was designed to determine the antibiotic susceptibility profile of clinical isolates of group B streptococcus(GBS, Streptococcus agalactiae) and to use the information for formulating appropriate intrapartum antibiotic policy for GBS carriage in pregnancy. Materials and Methods: A total of 1,166 clinical isolates (single isolates) of GBS obtained from vaginal/rectal samples of pregnant mothers seen at the Maternity Hospital, Kuwait were studied over a period of 43 months between May 1998 and December 2001. The isolates were identified by standard methods and their susceptibility to penicillin, ampicillin, cephalothin, clindamycin and erythromycin was determined by disk diffusion technique, minimal inhibitory concentration (MIC) using the Vitek automated sensitivity card system and E-test methods. Results: All the GBS isolates were fully susceptible to penicillin, ampicillin and cephalothin. Only 0.7 and 1.7% were resistant to erythromycin and clindamycin, respectively. Disk diffusion results interpreted by the standard interpretative criteria recommended by the National Committee on Clinical Laboratory Standards correlated well with Vitek results as well as the E-test for penicillin. The MIC of penicillin against all isolates ranged between 0.016 and 0.064 µg/ml. For the 6 months of 1998 and throughout 1999, the percentages of isolates susceptible at MICs of 0.016, 0.023, 0.032, 0.047 and 0.064 µg/ml were 6.5, 9.9, 31, 38.8 and 12%, respectively. The trend was similar in the subsequent years except that the percentage of isolates susceptible at MIC of 0.064 µg/ml increased to 26.6% in 2000, but went down to 4.4% in 2001. Conclusion: The trend in susceptibility of GBS to a variety of often used antibiotics for therapy and prophylaxis remained unchanged over nearly a 4-year period. The apparent increase in the number of isolates susceptible at higher MIC values of penicillin (0.047 and 0.064 µg/ml) in 2000 appears to be a bleb that cannot be explained by any event in the hospital for that year. Our data, based on susceptibility profiles, supports the use of penicillin or ampicillin for intrapartum chemoprophylaxis to prevent early-onset neonatal GBS infections.

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“…25-27]; however, in other areas, S. pyogenes still was fully suscep tible to clindamycin [28,29], Currently, 5. pyogenes is considered uniformly susceptible to penicillin G and V, amoxicillin, and cepha losporins, such as cefuroxime and cefixime [24,26,27,[29][30][31]. although tolerance to pen icillin associated with altered penicillin-bind ing protein patterns (altered PBP2, increase in PBP5) had been noted in vitro [32], Since the 1970s, the role of Streptococcus agctlacliae in cases of invasive systemic infec tions in newborns acquired intra-and post partum was appreciated [33][34][35], Lately, how ever, group B (3-hemolytic streptococci have been noted to cause invasive infections in adult patients with serious underlying ill nesses [36][37][38][39][40], In the past, this pathogen was susceptible to all (3-lactam antibiotics, specifi cally penicillin G, ampicillin, and all cepha losporins [41][42][43], and penicillin G as well as ampicillin proved effective for intrapartum chemoprophylaxis [33,34], However, strains with intermediate susceptibility to penicillin G (2%) and ampicillin (8%) were recently iso lated in Spain [44]; furthermore, 17% of the Antibiotic Susceptibility of (i-Hcmolytic Streptococci 100 isolates were tolerant to penicillin G. Serogroup C, F, and G (3-hemolytic strepto cocci have been known to cause pharyngitis, including several outbreaks, and occasional invasive systemic disease, e.g" septicemia, en docarditis, and meningitis [45][46][47][48], Penicillin G was traditionally considered the antibiotic of choice [49,50], However, the value of che motherapy in acute pharyngitis, the most ap propriate antibiotic and regimen, and the ef fect of antibiotic therapy on the incidence of sequelae remained uncertain [51], Very re cently, a case of group C streptococcal pharyn gitis [52] failed to ...…”

Section: Introductionmentioning

confidence: 99%

Comparative Susceptibility of Clinical Group A, B, C, F, and G β-Hemolytic Streptococcal Isolates to 24 Antimicrobial Drugs

Traub

Leonhard²

1997

Chemotherapy

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A total of 312 clinical β-hemolytic streptococcal isolates (Streptococcus pyogenes, group A = 63; Streptococcus agalactiae, group B = 145; group C = 50; group F = 27; group G = 27) were examined for susceptibility to 23 and 24 antimicrobial drugs with the Bauer-Kirby agar disk diffusion and the agar dilution method, respectively. Sheep blood Mueller-Hinton agar served as the reference medium. Wilkins-Chalgren agar supported optimal growth of group A and B, but not of all group C, F, and G streptococci. The group A streptococci were susceptible to all β-lactam antibiotics, clindamycin, chloramphenicol, rifampin, teicoplanin, and vancomycin, but resistant to cotrimoxazole, fusidic acid, and, except for 2 strains, to fosfomycin. Resistance (R)/intermediate susceptibility (I) rates (R/I%) to ciprofloxacin (0/2%), ofloxacin (1/2%), erythromycin (1.6 / 0%), and clarithromycin (0/1%) were low. Higher resistance rates were noted with tetracyclines (doxycycline 23.8/15.9%; tetracycline 39.7/3.2%). Among the group B streptococcal isolates, one strain was resistant against oxacillin and of intermediate susceptibility to penicillin G and cefoxitin. All isolates were susceptible to teicoplanin and rifampin. Conversely, all group B isolates were resistant to cotrimoxazole and fusidic acid; 69% and 51 % of these isolates were susceptible to fosfomycin and rifampin, respectively. R/I rates of the group B streptococcal isolates were low for ciprofloxacin and ofloxacin (0/0.7%), clindamycin (0.7/0%), erythromycin (1.4/ 3.5%), clarithromycin (1.4/0%), and chloramphenicol (0.7/0%). Resistance to tetracyclines was significant (doxycycline: 72.4/2.1%; tetracycline: 74.5/1.4%). Among the non-A, non-B β-hemolytic streptococci, 2 group C strains were resistant to oxacillin and showed intermediate susceptibility to penicillin G. All isolates were susceptible to third and fourth-generation cephalosporins, imipenem, chloramphenicol, rifampin, teicoplanin, and vancomycin. R/I rates to the other antimicrobial drugs were: ciprofloxacin (3.9/1.9%), ofloxacin (2.9/1.9%), clindamycin (2.9/1%), erythromycin (5.8/0%), clarithromycin (3.8/2.9%), and cotrimoxazole (16.4/3.9%). Resistance against tetracyclines was more frequent (doxycycline: 18.3/2.9%; tetracycline: 20.2/6.7%). On the basis of various minor discrepancies between MIC and disk diffusion test results, it is proposed that the current NCCLS inhibition zone (diameter, mm) criteria indicative of intermediate susceptibility of β-hemolytic streptococci be changed for the following antimicrobial drugs: ampicillin: 22-27 mm (only for group A and B β-hemolytic streptococci); ciprofloxacin: 16-18 mm; clindamycin: 15-18 mm; doxycycline: 17-19 mm; tetracycline: 17-19 mm, and erythromycin: 14-19 mm.

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Ampicillin Prevents Intrapartum Transmission of Group B Streptococcus

Cited by 187 publications

References 14 publications

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Antibiotic Susceptibility Profile of Group B Streptococcus <i>(Streptococcus agalactiae)</i> at the Maternity Hospital, Kuwait

Comparative Susceptibility of Clinical Group A, B, C, F, and G β-Hemolytic Streptococcal Isolates to 24 Antimicrobial Drugs

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