Group B Strep Treatment Questioned
Routine Antibiotics Given in Labor may not be Effective
Sep 6, 2009
A common test for expectant mothers at about 36-37 weeks of pregnancy is known as Group B Streptococcal (GBS). GBS is a bacteria that often is found in the digestive tract, vagina and urinary tract with no symptoms in adults.
However 1 in 2,000 newborns become infected with GBS and due to their immature immune system, they can have difficulty fighting off the spread of this bacteria. If a baby becomes infected with GBS, it can cause respiratory disease, meningitis, sepsis (an infection that spreads throughout the body) and even death.
Routine Treatment of IV Antibiotics
If your GBS test comes back positive, your care provider will typically recommend that you begin IV antibiotic treatment as soon as you arrive at your place of birth. Many providers recommend a treatment that includes a dosage of ampicillin every 4 hours until the baby is born. The antibiotics are considered to be effective after four hours have passed from the first dose.
However new evidence questions the effectiveness of routine antibiotics and in some cases, the treatment may even have negative effects.
Research Suggests that Antibiotics may not be Effective
A recent Cochrane review calls into question this routine practice to every mother testing positive for GBS. Their research indicates that when mothers were treated with antibiotics when they tested positive, it did decrease the risk of early GBS infection, but there was no difference in either late onset GBS or with neonatal sepsis between the groups who received IV antibiotics and those who did not. Antibiotics given in labor also did not decrease the incidence of newborn death.
Researchers point out that even if a GBS vaccine is developed, all cases of GBS related infections are not likely to be prevented.
(It is interesting to note that the researchers also suspect that the difference found in the early onset GBS was a result of bias in the studies that were a part of the review.)
Routine IV Antibiotics Can Cause Allergies and Yeast Infections
The downside is that treating all mothers with a positive GBS test with antibiotics during labor may cause other problems. One possible side effect is the potential for the mother to have an allergic reaction to the IV antibiotics. Not to mention, such early exposure of the baby to antibiotics can increase his or her problems with drug resistance later in life.
Another complication with antibiotic treatment is that it can cause mothers to develop yeast infections. Mothers and babies can then continue to pass persistent yeast infections back and forth through breastfeeding, known as thrush.
In summary, the reviewers found that, based on the studies they analyzed "giving antibiotics is not supported by conclusive evidence" as a routine treatment for GBS.
This is important information to share with your care provider when discussing your own birth plan especially if your GBS test comes back positive.
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