The Centers for Disease Control and Prevention (CDC) reported an algorithm for selecting an antibiotic to use for intrapartum prophylaxis against Group B Streptococcus (GBS).
Patient selection: pregnant woman who is a candidate for intrapartum prophylaxis against GBS
Parameters:
(1) allergy to penicillin
(2) history of severe allergic reaction to a penicillin or cephalosporin (angioedema, anaphylaxis, urticaria, respiratory distress)
(3) resistance to clindamycin
(4) resistance to erythromycin or evidence of inducible resistance to clindamycin
|
Penicillin Allergy |
Severe Reaction |
Resistance to Clindamycin |
Other Resistance |
Regimen |
|
no |
NA |
NA |
NA |
1 |
|
yes |
no |
NA |
NA |
2 |
|
yes |
yes |
no |
no |
3 |
|
yes |
yes |
no |
yes |
4 |
|
yes |
yes |
yes |
NA |
4 |
|
Regimen |
Details |
|
1 |
penicillin G 5 MU IV initial then 2.5 MU q4h until delivery |
|
1 (alternative) |
ampicillin, 2 g IV initial then 1 g IV q8h until delivery |
|
2 |
cefazolin, 2 g IV initial then 1 g IV q 8h until delivery |
|
3 |
clindamycin, 900 mg IV q8h until delivery |
|
4 |
vancomycin, 1 gram IV q12h until delivery |
Specialty: Infectious Diseases, Pharmacology, clinical, Obstetrics & Gynecology, Pedatrics
