Related Experiment Videos
Compliance with group B streptococcal disease prevention guidelines
L Chandran1, M Navaie-Waliser, N J Zulqarni
1Division of General Pediatrics, Department of Pediatrics, School of Medicine, State University of New York at Stony Brook, Stony Brook, NY, USA.
Insights
Clinician adherence to Group B Streptococcal (GBS) prevention guidelines for mothers and infants is suboptimal. Targeted education is needed to improve compliance and prevent early-onset GBS disease.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Medicine
- Infectious Disease Prevention
Background:
- Group B Streptococcal (GBS) disease remains a significant cause of early-onset neonatal infections.
- National guidelines exist to prevent GBS disease through maternal screening and intrapartum antibiotic prophylaxis.
- Assessing clinician compliance with these guidelines is crucial for effective disease prevention strategies.
Purpose of the Study:
- To evaluate clinician adherence to national guidelines for preventing early-onset Group B Streptococcal (GBS) disease in infants.
- To identify specific areas requiring educational interventions to improve clinician compliance with GBS prevention protocols.
Main Methods:
- A retrospective cohort study involving 515 mothers and 537 infants at a tertiary medical center.
- Evaluation of clinician compliance with GBS management algorithms for pregnant women and newborns at risk.
- Data collected on antibiotic administration, antenatal cultures, and infant evaluations post-delivery.
Main Results:
- Clinician compliance with intrapartum antibiotic prophylaxis for GBS ranged from 75% to 84% when indicated.
- Antenatal GBS cultures were performed in only 65% of indicated cases, with incorrect specimen site in 91%.
- Infant evaluations and post-discharge observations met guideline recommendations in varying percentages (14%-75% and 61%-94%, respectively).
Conclusions:
- Clinician compliance with current guidelines for preventing Group B Streptococcal disease in mothers and infants is not ideal.
- Significant gaps exist in the appropriate use of antenatal cultures and antibiotic prophylaxis.
- Targeted educational initiatives are necessary to enhance clinician adherence and improve GBS disease prevention outcomes.
Purpose:
This study assessed the degree of clinician compliance with nationally recommended guidelines for the prevention of early onset Group B Streptococcal (GBS) disease in infants. A secondary objective was to identify areas for specific educational interventions to enhance clinician compliance.
Study Design And Methods:
A hospital-based retrospective cohort study was undertaken at a tertiary medical center. Mothers (N = 515) with any known risk factor for GBS sepsis who delivered live infants (N = 537) in a 9-month study period participated. No interventions were done. Compliance of obstetric and pediatric clinicians with nationally recommended management algorithms for pregnant women and infants at risk for GBS disease was evaluated.
Results:
In the combined risk factor and culture-based algorithm for maternal management, clinician compliance with administration of intrapartum antibiotic prophylaxis (when indicated) ranged from 75% to 84%. Unindicated antibiotics were administered in 22% of the women. Among the women for whom antenatal cultures were indicated, 65% received them. Only 9% of the cultures were performed from the anogenital site, as recommended. In the risk factor-based maternal management algorithm, indicated antibiotics were administered to 76% of the women and unindicated antibiotics to 15% of the women. Use of penicillin, the recommended antibiotic, ranged from 0% to 9%. Among the infants, between 14% to 75% received recommended evaluations and 61% to 94% were observed for at least 48 hrs postdischarge.
Clinical Implications:
Clinician compliance with current GBS disease prevention guidelines for mothers and infants is less than ideal. Targeted education efforts are warranted.