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Infectious Diseases in Obstetrics and Gynecology
Volume 13 (2005), Issue 1, Pages 5-10
http://dx.doi.org/10.1155/2005/982060

Opportunities to Reduce Overuse of Antibiotics for Perinatal Group B Streptococcal Disease Prevention and Management of Preterm Premature Rupture of Membranes

1Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, USA
2Department of Research, American College of Obstetricians and Gynecologists, Washington, DC, USA
3Epidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, GA, USA
4Division of Maternal-Fetal Medicine, Vincent Memorial Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA
5Respiratory Diseases Branch, MS-C23, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, USA

Received 2 June 2004; Accepted 16 July 2004

Copyright © 2005 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective: To identify opportunities to reduce overuse of antibiotics for prevention of perinatal group B streptococcal (GBS) disease and management of preterm premature rupture of membranes (pPROM).

Methods: An anonymous written questionnaire was sent to each of 1031 Fellows of the American College of Obstetricians and Gynecologists, and the responses were subjected to statistical analysis.

Results: Among those of the 404 respondents who saw obstetric patients in 2001, most (84%) screened for GBS colonization, and 22% of these prescribed prenatal antibiotics to try to eradicate GBS colonization. Of the 382 respondents (95%) who prescribed antibiotics for pPROM, 36% continued antibiotics for more than 7 days despite negative results from GBS cultures collected before initiation of treatment. Having more years of clinical experience (adjusted odds ratio (OR) 3.0, 95% confidence interval (CI) 1.5 to 6.2), working in a non-academic setting (adjusted OR 2.7, 95% CI 1.0 to 6.9), and prescribing antibiotics prenatally for GBS colonization (adjusted OR 2.0, 95% CI 1.1 to 3.4) were associated with prescribing prolonged antibiotics for pPROM.

Conclusion: Prenatal antibiotic treatment for GBS colonization and prolonged antibiotic treatment for pPROM contribute to overuse of antibiotics in obstetrics.