Intrapartum antibiotics for known maternal Group B streptococcal colonization

Ohlsson, Arne; Shah, Vibhuti

doi:10.1002/14651858.cd007467.pub4

Cited by 68 publications

(50 citation statements)

References 72 publications

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“…By reading the abstracts and using our criteria, 41 studies were selected for detailed evaluation; 30 studies were excluded for the reasons noted in Figure 1. Three studies were included through manual searches of the relevant systematic reviews and reference list (Egarter et al, 1996; Benitz et al, 1999; Ohlsson and Shah, 2014). Finally, 14 studies were included in the final analysis (Yow et al, 1979; Easmon et al, 1983; Boyer and Gotoff, 1986; Lim et al, 1986; Tuppurainen and Hallman, 1989; Matorras et al, 1991; Gervasio et al, 2001; EI Helali et al, 2009; Li and Meng, 2010; Shen et al, 2012; Bai, 2014; Ma et al, 2014; Yang, 2015; Zhang et al, 2015).…”

Section: Resultsmentioning

confidence: 99%

Antibiotic Prevention for Maternal Group B Streptococcal Colonization on Neonatal GBS-Related Adverse Outcomes: A Meta-Analysis

Huang

Chen

et al. 2017

Front. Microbiol.

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Maternal colonization with group B Streptococcus (GBS) during pregnancy increases the risk of neonatal infection by vertical transmission. However, it remains unclear whether treating all colonized women during labor exposes a large number of their neonates to possible adverse effects without benefit. We performed a meta-analysis to assess the effect of intrapartum antibiotic prophylaxis on neonatal adverse outcomes. We identified studies by searching several English and Chinese electronic databases and reviewing relevant articles. Data were pooled using fixed-effects or random-effects meta-analysis, and for each outcome both risk ratio (RR) and 95% confidence intervals (95% CIs) were calculated. Fourteen studies (2,051 pregnant women and 2,063 neonates) were included, comprising 13 randomized clinical trials and 1 cohort study. Antibiotic prophylaxis is associated with a significant reduced risk of all cause infections (RR = 0.28, 95% CI = 0.18–0.42), GBS infection (RR = 0.24, 95% CI = 0.13–0.44), early-onset GBS infection (RR = 0.24, 95% CI = 0.13–0.45), non-GBS infections (RR = 0.34, 95% CI = 0.20–0.59), and GBS colonization (RR = 0.10, 95% CI = 0.06–0.16). But no significant reduction was observed in late-onset GBS infection, mortality from early-onset GBS infection or from non-GBS infections. Notably, no significant differences were found between ampicillin and penicillin prevention for neonatal adverse outcomes. Our findings suggest that antibiotic prophylaxis is effective in reducing neonatal GBS colonization and infection.

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Section: Resultsmentioning

confidence: 99%

Antibiotic Prevention for Maternal Group B Streptococcal Colonization on Neonatal GBS-Related Adverse Outcomes: A Meta-Analysis

Huang

Chen

et al. 2017

Front. Microbiol.

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“…39 Clinical trials in the 1980s demonstrated that IAP reduced the incidence of early neonatal GBS disease and has formed the basis of IAP strategy 4041 A Cochrane review highlighted a statistically significant reduction in the early-onset neonatal GBS disease following IAP compared with no treatment, where in industrialised countries the number needed to treat to benefit was 25 (95% CI 14 to 100) 42…”

Section: Intravenous Intrapartum Antibiotic Strategy To Prevent Earlymentioning

confidence: 99%

Challenges in reducing group B Streptococcus disease in African settings

et al. 2016

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Group B Streptococcus (GBS) is a leading cause of neonatal sepsis and meningitis in high-income settings and is associated with high rates of neonatal mortality and morbidity. There is now increasing evidence to suggest that there is a high GBS disease burden in resource-limited countries, and it is therefore critically important to identify suitable and practical preventive strategies. In Europe and North America, intrapartum antibiotic prophylaxis (IAP) has led to a dramatic reduction of early-onset GBS disease. However, the methods for identifying pregnant women who should receive IAP and how to reduce late-onset GBS disease are not without controversy and are challenging for most sub-Saharan African countries. GBS vaccines are approaching phase III trials but are still under development. This review aims to explore the current evidence related to strategies for reducing invasive GBS disease in an African setting, the development of a GBS vaccine and whether preventative measures against GBS disease can be practically implemented.

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“…1,2 Intrapartum antibiotic prophylaxis for GBS-colonized women has resulted in a significant reduction in early-onset neonatal GBS infection. 3 The obstetric and pediatric GBS guidelines, released in 2010 and 2011, respectively, by the Centers for Disease Control and Prevention (CDC) state that "penicillin remains the agent of choice for intrapartum antibiotic prophylaxis, with ampicillin as an acceptable alternative. Penicillin-allergic women who do not have a history of anaphylaxis, angioedema, respiratory distress or urticaria following administration of a penicillin or cephalosporin should receive cefazolin."…”

mentioning

confidence: 99%