Revised guidelines for prevention of early-onset group B streptococcal (GBS) infection

In 1992, the Committee on Infectious Diseases and Committee on Fetus and Newborn of the American Academy of Pediatrics provided guidelines for prevention of early-onset group B streptococcal (GBS) disease through intrapartum chemoprophylaxis of selected maternal GBS carriers. The guidelines were based on demonstrated efficacy in randomized, controlled clinical trials and selected only women with GBS colonization who had an obstetric risk factor. The guidelines were controversial and their implementation incomplete. Since 1992, additional data have become available, and experience with the guidelines has been gained in numerous medical centers. Recently, consensus guidelines were developed by obstetricians, pediatricians, family practitioners, and public health authorities and published by the Centers for Disease Control and Prevention. These recommendations are supported by the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics. This statement reviews the selection of pregnant women for chemoprophylaxis and provides an algorithm for management of their newborns.