Group B Streptococcus Agalactiae (GBS) Prophylaxis

• A common cause of sepsis in neonates.
• Prophylaxis should be given intravenously and intrapartum only.
• These antimicrobials are for GBS prophylaxis only. If chorioamnionitis is suspected, broader spectrum cover is necessary.
• If membranes have not ruptured and birth is by caesarean section the following prophylactic drug treatment is unnecessary.

Drug Treatment

• Duration: From labour onset until delivery.

benzylpenicillin HMLSchedNZFPMLnoids Benzylpenicillin F: n/a Half life: 1 hour Elimination: hydrolysis fe: 0.9 (Penicillin G)

IV 3 g (5 megaunits) initially then IV 1.8 g (3 megaunits) every four hours

• fe = 0.8, consider adjusting dose if CrCl is reduced.

Mild penicillin allergy

cefazolin HMLSchedNZFPMLnoids Cefazolin F: n/a Half life: 2 hours Elimination: renal fe: 0.9

IV 2 g initially then IV 2 g every eight hours

• fe = 0.9, consider adjusting dose if CrCl reduced.

Severe penicillin allergy

vancomycin HMLSchedNZFPMLnoids Vancomycin F: n/a Half life: 6 hours Elimination: renal fe: 0.9 Additional points: TDM

IV 1 g every twelve hours

• fe = 0.9, adjust dose if CrCl reduced.
• Must be given diluted (1 g in at least 200 mL) and slowly (≤ 1000 mg/hour) to minimise infusion reactions.

Topic Code: 99238

must be prescribed or recommended by a consultant.