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Related Experiment Videos

Strategies to decrease costs associated with GBS prophylaxis in preterm gestations.

Nguyen1, Guinn, Rodriguez

  • 1University of Illinois at Chicago, Illinois, Chicago, USA

Primary Care Update for Ob/Gyns
|June 6, 2000
PubMed
Summary

Routine Group B Streptococcus (GBS) cultures for preterm delivery risk have limited clinical value and incur significant costs. Empiric antibiotics in preterm labor and PROM cases often lead to overtreatment and unnecessary charges.

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Infectious Disease in Pregnancy

Background:

  • Group B Streptococcus (GBS) screening is crucial for preventing neonatal infections.
  • Current practices involve routine GBS culturing for high-risk pregnancies, including preterm delivery.
  • The cost-effectiveness and clinical utility of these practices require evaluation.

Purpose of the Study:

  • To assess the financial costs of routine GBS culturing in women at risk for preterm delivery.
  • To evaluate the charges associated with empiric antibiotic therapy for suspected imminent delivery before 37 weeks.
  • To determine the clinical impact of GBS culture results on management decisions.

Main Methods:

  • Retrospective analysis of records for women with preterm contractions, preterm labor (PTL), and preterm rupture of membranes (PROM).

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  • GBS cultures were performed, with Lim broth culture as the gold standard.
  • Costs calculated for GBS cultures and intravenous ampicillin administration.

    • Main Results:

    • GBS incidence was 12.7% in preterm contractions, 11.5% in PTL, and 20.3% in PROM.
    • Culture results guided care in only 5.5% of preterm contraction cases, costing $3776.
    • Empiric antibiotics were given to most PTL and PROM patients, often before results were available, leading to potential overtreatment and significant charges.

    Conclusions:

    • Routine GBS culturing offers limited clinical value in women with preterm contractions and preterm labor.
    • Empiric antibiotic use in PTL and PROM may be excessive, suggesting antibiotics should be reserved for specific indications.
    • The cost savings from not performing GBS cultures in PROM were estimated at $2048, highlighting the financial implications of current protocols.