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

Am J Obstet Gynecol. 2011 Feb;204(2):150.e1-8. doi: 10.1016/j.ajog.2010.08.063. Epub 2010 Dec 17.

Abstract

Objective: The purpose of this study was to compare adherence to the 2002 Centers for Disease Control (CDC) guidelines for the prevention of perinatal group B Streptococcus (GBS) disease in patients who are allergic to penicillin during the years 2004-2006 and 2008.

Study design: Previous data from our institution revealed suboptimal adherence to the 2002 CDC guidelines for GBS prophylaxis among women who are allergic to penicillin. These data caused the hospital to implement a series of interventions. The original cohort (2004-2006) was compared with a cohort of women who delivered between April 2008 and January 2009 (n = 74) to determine whether the proportion of women who had antimicrobial sensitivity testing and who had received an appropriate antibiotic had improved.

Results: In 2008, 76% (95% confidence interval, 66-84%) of GBS-positive women who are allergic to penicillin received an appropriate antibiotic (compared with 16.2% in 2004-2006; P < .001). Antimicrobial sensitivity testing was performed in 79.4% of cases (95% confidence interval, 68-87%), compared with 11.4% in 2004-2006 (P < .001).

Conclusion: With directed intervention, adherence to the 2002 CDC guidelines for GBS prophylaxis in women who are allergic to penicillin improved dramatically.

MeSH terms

  • Antibiotic Prophylaxis
  • Centers for Disease Control and Prevention, U.S.
  • Drug Hypersensitivity / immunology*
  • Female
  • Follow-Up Studies
  • Guideline Adherence
  • Humans
  • Penicillins / adverse effects*
  • Penicillins / immunology
  • Practice Guidelines as Topic
  • Pregnancy
  • Pregnancy Complications, Infectious / immunology
  • Pregnancy Complications, Infectious / prevention & control*
  • Retrospective Studies
  • Streptococcal Infections / immunology
  • Streptococcal Infections / prevention & control*
  • Streptococcus agalactiae / immunology*
  • United States

Substances

  • Penicillins