How to prevent GBS infection

Reproduced with kind permission of Group B Strep Support.

Waiting to give antibiotics to the baby after delivery will sometimes be too late. Clinical randomised medical trials have proven that most early-onset GBS infection can be prevented by giving intravenous antibiotics (through a vein) from the onset of labour through until delivery to women whose babies are at increased risk.

Research shows intravenous antibiotics take between 2 and 3 hours to cross the placenta and reach therapeutic levels in the baby, although lesser times have proved beneficial: something is better than nothing.

Babies who develop GBS infection can require long stays in hospital and expensive supportive treatment.

Our medical advisory panel has made the following recommendations which are, we believe, the most appropriate for Britain in the light of all currently available data. They will need periodic reappraisal to incorporate advances in technology, new research or other refinements.

Prevention Strategy

Intravenous AntibioticsTo stop as many cases of GBS infection in newborn babies as possible, women with any risk factor would need to be given intravenous antibiotics during labour for ideally at least 4 hours before delivery.

Some women will prefer not to receive antibiotics if their risk is only slightly increased since it would inevitably complicate an otherwise natural birth, plus antibiotic therapy is associated with rare but significant complications. The risk of a GBS infection in the baby must be balanced against the wishes and beliefs of the woman in labour and against her risk of an adverse reaction to the antibiotics.

Medical research shows the chance of a baby developing early-onset GBS infection can be reduced by over 70% (and the number of fatalities by 75-80%) by adopting the following measures.

Medical Advisory Panel’s Recommendations

Our medical advisory panel’s 6 key recommendations for preventing GBS infection in newborn babies are:
*women whose babies are at increased risk of developing GBS infection should be offered antibiotics immediately at the onset of labour or rupture of membranes (this includes women *known to carry the GBS bacteria where no other risk factors are present, and women not *known to carry the GBS bacteria but who have another risk factor present).
*women whose babies are at particularly high risk should be strongly advised to accept intravenous antibiotics immediately at the onset of labour or rupture of membranes until delivery (this includes women who are known GBS carriers with one or more clinical risk factors and *women who have previously had a baby infected with GBS, regardless of other risk factors. It also includes women who are not known to be GBS carriers but who have multiple risk factors).
for women in labour, the recommended doses of penicillin G are 3 g (or 5 mU) intravenously initially and then 1.5 g (or 2.5 mU) at 4-hourly intervals until delivery. For women who are allergic to penicillin, the recommended doses of clindamycin are 900 mg intravenously every 8 hours until delivery.
*intravenous antibiotics should be given for at least 4 hours prior to delivery where possible.  Babies born in situations where there is increased risk and the mother has received at least 4 hours of intravenous antibiotics should be assessed carefully by a paediatrician and, if completely healthy, intravenous antibiotics should not be given to them (see paediatric prevention).
*babies born in a higher risk situation where the mother has not received at least 4 hours of intravenous antibiotics should be investigated and initially commenced on antibiotics until it has been proven the baby is not infected.

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