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GROUP B STREPTOCOCCUS

The vagina or rectum is colonized with group B streptococcus (GBS) in 10 to 40 percent of women.7,8 Early-onset GBS disease is the most common cause of serious infection during the newborn period; it occurs in one in 1,000 births.7 Universal screening consisting of a lower vaginal and rectal swab at 35 to 37 weeks' gestation and appropriate intrapartum chemoprophylaxis in GBS-positive women reduces the incidence of early-onset infections in neonates.8 unless the bacteria are cultured from urine, there is no need for GBS treatment until the onset of labor. I if GBS status is unknown at the start of labor, many physicians choose to treat prophylactically; however, this strategy is not recommended by the Centers for Disease Control and Prevention (CDC).8 E exceptions to these recommendations are noted in online Figure A, which is an algorithm for the prophylaxis of GBS during labor.8

In women who test positive for GBS or have other indications for prophylaxis, antibiotic therapy should be instituted at the onset of labor. Currently, preferred treatment consists of at least one dose of intravenous penicillin (5 million units) given a minimum of four hours before delivery. If labor continues beyond four hours, subsequent doses (2.5 million units) should be given every four hours until delivery. A although there is concern that GBS strains are becoming resistant to routinely administered antibiotics, no recent statistically significant increase in resistance has been noted.9 ampicillin remains an alternative to penicillin; options for penicillin-allergic patients include cefazolin (Kefzol; brand not available in the U united S states), clindamycin (Cleocin), erythromycin, or vancomycin (Vancocin).8 T the CDC recommends treatment based on GBS sensitivity patterns in women who are at high risk of anaphylaxis with penicillin.8

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  • 1 decade ago
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    組 B 鏈球菌

    陰道或直腸 10 至 40 %的 women.7,8 早發病的組 B 鏈球菌 (GBS) 與移植 GBS 疾病是新生兒期的嚴重感染的最常見原因 ; 發生在一個在 1,000 births.7 通用篩選由組成的一個較低的陰道和直腸拭子在 35 至三十七個星期妊娠和 GBS 陽性婦女的適當產時預防減少 neonates.8 早發性感染的發生率,除非這種細菌是培養從尿,有直到發病的勞動 GBS 治療無需。 我如果 GBS 狀態未知開頭的勞動,很多醫師選擇治療 prophylactically ; 但是、 疾病控制中心的不推薦這種策略,這些建議的預防).6 E 例外情況在連線是一種演算法的期間 labor.8 GBS 預防的圖 A 中記下

    GBS 的試驗積極或有其他指征預防婦女在發病的勞動提起抗生素治療。 目前,首選的治療由至少一個劑量的靜脈青黴素 (5 萬單位) 發出最少在遞送前四個小時的組成。 勞動超過 4 小時下去後續劑量 (250 萬單位),應獲得傳遞至每四小時。 A 雖然關注 GBS 株越來越抗定期管理抗菌藥物不最近的電阻統計顯著增加,已 noted.9 苄青黴素仍然青黴素的備選 ; 青黴素變態反應性病人的選項包括頭孢唑林 (Kefzol ; 品牌,U 中不可用 S 美國),克林黴素 (Cleocin),紅黴素或萬古黴素論治中有過敏反應與 penicillin.8 高危婦女 GBS 敏感性模式的 (Vancocin).6 T 課程發展議會建議

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