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Group B Streptococcus prophylaxis in patients who report a penicillin allergy: a follow-up study

Agatha S Critchfield1, Stacey P Lievense, Christina A Raker

  • 1Division of Research, Department of Obstetrics and Gynecology, Women and Infants Hospital, The Warren Alpert Medical School at Brown University, Providence, RI, USA.

American Journal of Obstetrics and Gynecology
|December 21, 2010
PubMed

Insights

Adherence to Centers for Disease Control (CDC) guidelines for preventing group B Streptococcus (GBS) in penicillin-allergic patients significantly improved after targeted interventions. Appropriate antibiotic use and antimicrobial sensitivity testing increased substantially in 2008 compared to 2004-2006.

Area of Science:

  • Obstetrics and Gynecology
  • Infectious Disease Prevention
  • Clinical Practice Guidelines

Background:

  • Suboptimal adherence to 2002 Centers for Disease Control (CDC) guidelines for group B Streptococcus (GBS) prophylaxis was noted in penicillin-allergic patients.
  • Previous institutional data highlighted deficiencies in GBS prevention protocols for this specific patient group.

Purpose of the Study:

  • To compare adherence to 2002 CDC guidelines for perinatal GBS disease prevention in penicillin-allergic patients.
  • To evaluate the impact of hospital-implemented interventions on GBS prophylaxis adherence.

Main Methods:

  • A comparative study design was employed, contrasting a 2004-2006 cohort with a 2008-2009 cohort (n=74).
  • The study assessed the proportion of GBS-positive, penicillin-allergic women who received appropriate antibiotic prophylaxis and underwent antimicrobial sensitivity testing.

Main Results:

  • In 2008, 76% of GBS-positive penicillin-allergic women received appropriate antibiotics, a significant increase from 16.2% in 2004-2006 (P < .001).
  • Antimicrobial sensitivity testing increased from 11.4% in 2004-2006 to 79.4% in 2008 (P < .001).

Conclusions:

  • Targeted interventions led to a dramatic improvement in adherence to CDC guidelines for GBS prophylaxis in penicillin-allergic women.
  • The findings demonstrate the effectiveness of focused strategies in enhancing clinical practice for preventing GBS disease.
Abstract

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