Universal screening and maternal chemoprophylaxis for Group B Streptococcus and its effect on management of mildly symptomatic term infants

Academic Article

Abstract

  • OBJECTIVE: To evaluate the effect of universal screening and treatment of culture positive women for Group B Streptococcus on the management of mildly symptomatic, term infants RESEARCH DESIGN: Mail survey of all practicing pediatricians in Tennessee METHOD: Pediatricians (N=575) were mailed surveys, which consisted of 14 patient care scenarios, requiring respondents to indicate their preference for diagnostic evaluations and treatments. These scenarios differed with respect to presence or absence of prolonged rupture of membranes (ROM) and symptomatology of the term infant (hypothermia or poor feeding). The scenarios also varied with respect to maternal GBS culture status (positive or negative) and intrapartum treatment with antibiotics. RESULTS: Completed surveys were returned by 276 pediatricians. Preliminary analysis of the data revealed the following: Depending on the scenario, pediatricians varied widely in their use of diagnostic tests and decisions to treat. For instance, obtaining blood cultures ranged from 20% to 76%, ordering CBC's ranged from 31% to 82%; while the decision to treat with antibiotics ranged from 4% to 46%. These differences appeared to be related to respondents knowledge of maternal GBS culture status. Logistic regression analysis will be performed in order to assess the relative effect of clinical, practice and individual physician characteristics on pediatricians' decisions to order diagnostic tests and prescribe antibiotics. CONCLUSION: Decisions to order diagnostic tests or to treat mildly symptomatic infants with antibiotics appear to be strongly influenced by pediatricians' knowledge of positive maternal GBS culture status.
  • Published In

    Author List

  • Gigante J; Hickson GB; Fargason CA; Peralta-Carcelen M; Miller CS
  • Volume

  • 44
  • Issue

  • 1