2. Improving Prophylactic Treatment of GBS Positive Patients Michelle Blythers Literature Review Presentation Senior Project October 22, 2014

3. Introduction A high priority should be placed on identifying Group B Streptococcus (GBS) positive mothers and the appropriate administration (>4 hours prior to delivery) of prophylactic antibiotics.

4. Importance of Change: GBS is the leading cause of sepsis, pneumonia and meningitis in the early newborn period, which is defined a the first week of life. Identifying/screening and adequately treating GBS positive mother’s, increases positive patient outcomes.

5. Article #1 Berardi, A.,Rossi,C.,Biasini, A. Minnitti, S., Venturelli, C., Ferrari, Faccinetti, F. (2011) Efficacy of intrapartum chemoprophylaxis less than 4 hours duration. The Journal of Maternal-Fetal and neonatal medicine 21(4): 619-625  The data in this article were collected over 12 months, in 2 different hospitals.  This was a quantitative study to compare rate of vertical transmission of GBS in women with no other risk factors.  The findings were valid.

6. Article #2 Turrentine, M. Greisinger, A., Brown, K., Wehmanen, O., Mouzoon, M. (2013). Duration of intrapartum antibiotics for group b streptococcus on the diagnosis of clinical neonatal sepsis. Infectious Disease in obstretrics and Gynocology, 1-6.doi:10.1155/2013/525878  This particular study was done in a large facility which delivers over 8,000 infants a year.  It was retrospective cohort study of.  The results were that infants whose mothers received <4 hours intrapartum antibiotic therapy, were more often diagnosed with clinical sepsis.

7. Article #3 Silva, J., Stein, A., Schunemann, H., Bordin, R. Kuchenbecker, R., Drachler, M. (2013), Academic detaling and adherence to guidelines for group b streptococci prenatal screening: a randomized controlled study. BMC Pregnancy & Childbirth 2013, 13:68 http://www.biomedcentral.com/1471- 2393/13/68.  This was a random controlled study consisting of physicians  It is imperative that health care workers stay abreast of the latest guidelines so that they can properly teach the patients.  The results proved that academic detailing increased the prevalence of GBS screening in that particular population.

8. Summary: The research studies presented all provide sufficient evidence that supports the CDC recommended guidelines.  Article #1 is a level IV. Evidence from a well-designed case-control and cohort study.  Article #2 is a level IV. Evidence from a well-designed case-control and cohort study.  Article #3 is a level II. Evidence obtained from a well- designed Randomized Controlled Trial.