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Infectious Diseases in Obstetrics and Gynecology
Volume 2009, Article ID 934698, 11 pages
http://dx.doi.org/10.1155/2009/934698
Research Article

Cost-Effectiveness of Universal Prophylaxis in Pregnancy with Prior Group B Streptococci Colonization

Department of Obstetrics, Gynecology and Reproductive Sciences, Kelsey Research Foundation, University of Texas Medical School, Houston, TX 77007, USA

Received 10 May 2009; Revised 7 September 2009; Accepted 8 October 2009

Academic Editor: Austin Ugwumadu

Copyright © 2009 Mark A. Turrentine et al. 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 estimate the costs and outcomes of rescreening for group B streptococci (GBS) compared to universal treatment of term women with history of GBS colonization in a previous pregnancy. Study Design. A decision analysis model was used to compare costs and outcomes. Total cost included the costs of screening, intrapartum antibiotic prophylaxis (IAP), treatment for maternal anaphylaxis and death, evaluation of well infants whose mothers received IAP, and total costs for treatment of term neonatal early onset GBS sepsis. Results. When compared to screening and treating, universal treatment results in more women treated per GBS case prevented (155 versus 67) and prevents more cases of early onset GBS (1732 versus 1700) and neonatal deaths (52 versus 51) at a lower cost per case prevented ($8 805 versus $12 710). Conclusion. Universal treatment of term pregnancies with a history of previous GBS colonization is more cost-effective than the strategy of screening and treating based on positive culture results.