Can you briefly tell me your Group B protocol?

**LibraSunCNM, BSN, MSN, CNM** · Mar 28, 2012

Ours has changed recently too, I think for the better, because compared to what I've read about protocols elsewhere in the U.S. and abroad, our policy was way too conservative.

So we used to treat every mom and baby with Pen G if she was GBS positive OR unknown in L&D. Now the policy is if mom is positive, she is treated with Pen G after rupture of membranes every 4 hours I believe. If this treatment is given, we just observe the baby for signs of sepsis. If she was "inadequately" treated, i.e. it was more than 4 hours between her last dose and the delivery, or if she came in too late to get the Pen G at all, we also observe the baby, but call the pediatrician and it's up to them if they want us to draw a CBC with differential on the baby. So far none of them have ordered that and just have us observe.

RNLaborNurse4U · Mar 28, 2012

We overtreat. All known +GBS women get PCN Q 4 hrs in active labor, until birth. (Or the alternative antibiotic regimen if PCN allergic). Known -GBS women do not get antibiotics. Unknown GBS status, are all treated as if positive GBS. (Not following CDC guidelines to only treat if risk factors are present!) We also treat with antibiotics if mom is GBS neg, but ROM x 18 or more hours and no s/s of infection (once again, not following CDC guidelines!).

klone, MSN, RN · Mar 29, 2012

All GBS+ women are treated once they're in active labor if they're having a lady partsl delivery. That's it. Q4 with PenG, or q8 if it's one of the other abx.

melmarie23, MSN, RN · Mar 30, 2012

So we used to treat every mom and baby with Pen G if she was GBS positive OR unknown in L&D. Now the policy is if mom is positive, she is treated with Pen G after rupture of membranes every 4 hours I believe. If this treatment is given, we just observe the baby for signs of sepsis. If she was "inadequately" treated, i.e. it was more than 4 hours between her last dose and the delivery, or if she came in too late to get the Pen G at all, we also observe the baby, but call the pediatrician and it's up to them if they want us to draw a CBC with differential on the baby.

this exactly, except the ROM part. we treat q4 once in active labor for pos GBS or unknown status.