Format

Send to

Choose Destination
Int J Gynaecol Obstet. 2015 Apr;129(1):9-12. doi: 10.1016/j.ijgo.2014.10.018. Epub 2014 Dec 18.

Vaginal group B streptococcus status during intrapartum antibiotic prophylaxis.

Author information

1
Department of Obstetrics and Gynecology, Pereira Rossell Hospital, University of Uruguay, Montevideo, Uruguay. Electronic address: sscasso@gmail.com.
2
Department of Obstetrics and Gynecology, Pereira Rossell Hospital, University of Uruguay, Montevideo, Uruguay.
3
Department of Microbiology, University of Uruguay, Montevideo, Uruguay.
4
Department of Obstetrics and Gynecology, Pereira Rossell Hospital, University of Uruguay, Montevideo, Uruguay; Department of Epidemiology, University of Uruguay, Montevideo, Uruguay.

Abstract

OBJECTIVE:

To assess maternal group B streptococcus (GBS) colonization status and the pharmacokinetic profile of penicillin G in the umbilical cord and amniotic fluid compartment during 4 hours of intrapartum antibiotic prophylaxis (IAP).

METHODS:

In a prospective study at a hospital in Montevideo, Uruguay, 60 GBS carriers in active labor after a singleton pregnancy of 37 weeks or more were enrolled between April 1, 2011, and April 30, 2012. Intravenous penicillin G was administered via a standard regimen. Rectovaginal samples were obtained before IAP initiation, and 2 and 4 hours after the initial dose. Penicillin G concentrations were measured by high-performance liquid chromatography. Samples were obtained from fetal cord blood in all cases and from amniotic fluid obtained from patients who delivered by cesarean.

RESULTS:

Among the 60 participants, 43 (72%) had a positive rectovaginal sample before IAP initiation. Of these women, 23 (53%) had negative cultures after 2 hours; after 4 hours, only 5 (12%) remained positive for GBS. The penicillin G concentration in amniotic fluid and cord blood was above the minimum inhibitory concentration (0.12 μg/mL) in all cases.

CONCLUSION:

Four hours of IAP was needed to reduce the number of women with positive GBS cultures to 12%. Therefore, 4 hours of IAP might be necessary to achieve overall effectiveness from this treatment.

KEYWORDS:

Group B streptococcus; Intrapartum antibiotic prophylaxis; Penicillin

PMID:
25577036
DOI:
10.1016/j.ijgo.2014.10.018
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center