Compliance With Guidelines on Group B Streptococcal Sepsis Prophylaxis During Unscheduled Cesareans [22M

Abstract

INTRODUCTION: In 2013, compliance with the American College of Obstetrics and Gynecology (the College) guidelines for Group B streptococcus (GBS) prophylaxis was 69.6% at our institution. In non-compliant cases, 80% were due to lack of antibiotics. Afterward, improving GBS prophylaxis was emphasized during an Obstetrics and Gynecology Section meeting, but no formal education was provided. The objective of this project was to assess whether there has been an improvement in compliance with prophylaxis for GBS. METHODS: Retrospective review of GBS positive women confirmed at term gestation, who delivered via unscheduled cesarean from October 2014 to March 2015 was performed. Women were included if gestational age at delivery was 37-39 weeks, and spontaneous rupture of membranes or active labor was documented prior to delivery. Compliance was determined based on evidence of appropriate antibiotics for GBS according to the College guidelines. RESULTS: Of 43 patients reviewed, 31 met inclusion criteria. The majority of women 38 weeks gestation (45.2%, n=14). Rectovaginal swab confirmed GBS positive status in 24 (77.4%) cases. The majority of women delivered via primary cesarean (54.8%, n=17). Out of 31 cases, 26 (83.9%) were compliant with the College guidelines on GBS prophylaxis. Of the non-compliant cases, 4 of the 5 (80%) were due to no evidence of antibiotics being administered for GBS. There were 3 (9.7%) cases in which antibiotics were not given for surgical prophylaxis. CONCLUSION: Adherence to GBS prophylaxis guidelines improved since 2013, but failing to administer any antibiotics continues to be the primary reason for non-compliance.