Who needs GBS prophylaxis?

IAP indicated: positive GBS culture at 36+ weeks, GBS bacteriuria any trimester, prior infant with invasive GBS disease, unknown GBS status with delivery 18h or fever ≥38°C.

What antibiotics are used for GBS prophylaxis?

Penicillin G 5 million units IV load, then 2.5-3 million units IV q4h is first choice. Ampicillin 2g IV then 1g q4h is alternative. Penicillin-allergic: clindamycin if susceptible; vancomycin for resistant strains.

How effective is GBS prophylaxis?

IAP reduces early-onset GBS (EOGBS) neonatal disease by ~80%. EOGBS incidence fell from 1.7/1000 births pre-prevention to 0.23/1000 births with universal culture-based screening. Late-onset GBS (after day 7) is not prevented by IAP.

GBS Intrapartum Antibiotic Prophylaxis Decision Tool

Apply CDC/ACOG 2020 guidelines for group B Streptococcus (GBS) intrapartum antibiotic prophylaxis (IAP) decision. Culture-based approach: positive GBS culture, bacteriuria, or prior affected infant mandates penicillin G prophylaxis.

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