2009 Southern Regional Meeting Abstracts

Purpose of Study: The purpose of the study is to examine the medical management of asymptomatic neonates born at term either to mothers who are Group B Streptococcus (GBS) unknown or to mothers who are GBS positive but “inadequately” treated prior to delivery.
Methods Used: The study design was a chart review of mother/baby dyads born at the Medical College of Georgia from January 1, 2005 until September 30, 2007 and cared for in the Newborn Nursery, which is staffed by general pediatricians. The protocol is to obtain a Complete Blood Count with a Differential, a blood culture, and C-reactive protein immediately after birth. Then, based on the results of these lab tests a decision to start antibiotics is made.
Summary of Results: Mother/baby dyads (n=242) who met the following inclusion criteria were reviewed: term, mother’s GBS status unknown or positive, no antibiotics or antibiotics less than 4 hours prior to delivery, and a laboratory evaluation in the newborn nursery. Of these 242 babies 25 (10%) were started on antibiotics. Antibiotic therapy was discontinued after 48 hours on 23 out of the 25 babies that were started on antibiotics, and the other 2 babies received 7 days of antibiotics for signs of clinical sepsis. None of the 242 blood cultures were positive and the C-reactive protein levels were normal.
Conclusions: The 2002 GBS guidelines call for laboratory evaluation for “at-risk” neonates, but the workup of these babies is not only costly, it does not provide any advantage over good old fashioned clinical observation for the evaluation and treatment of early onset GBS sepsis.

	# of Babies	# Babies Tx	Positive Cx
GBS ? No Abx	36	8	0
GBS ? 1 dose Abx	25	1	0
GBS + No Abx	51	5	0
GBS + 1 dose Abx	130	11	0
Totals	242	25	0