1067 SELECTIVE INTRAPARTUM CHEMOPROPHYLAXIS OF EARLYONSET GROUP B STREPTOCOCCAL DISEASE

Abstract

We examined the effect of selective intrapartum chemoprophylaxis (SIC) on the incidence of group B streptococcal (GBS) early-onset disease in a randomized controlled trial. Parturients were eligible for the study if they had prenatal GBS colonization and either premature labor (<37 weeks) or prolonged membrane rupture (>12 hours). Treated mothers received 2 gm ampicillin IV followed by 1 gm IV Q4H until delivery. Blood cultures were obtained from all study infants at birth and from mothers or older infants if warranted clinically. Of the 175 randomized parturients, 93 received ampicillin and 82 did not. No infant whose mother received SIC had GBS early-onset bacteremia, whereas 5 (6.1%) of the infants whose mothers were not treated were bacteremic (p=0.02). We studied an additional 320 nonrandomized women with the same eligibility criteria. None of the infants born to 76 treated mothers had GBS early-onset bacteremia, whereas 7 of 224 (3.1%) whose mothers were not treated were bacteremic (p=0.13). Four untreated mothers (1 randomized, 3 nonrandomized) developed GBS obstetric sepsis. One infant born to a nonrandomized treated mother developed GBS late-onset sepsis. These results are the first prospective demonstration of the efficacy of SIC to prevent GBS invasive disease.

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