GBBS to treat or not to treat

  1. 0
    Just wondering...If a GBBS culture was done at 31-32 weeks and result was negative, and mom delivers at fullterm do your OB's usually treat w/ antibiotics? I was told that a culture this early can be a false negative? Thanks!
  2. 10 Comments so far...

  3. 0
    The OBs I worked with usually retested at 35-36 weeks and then based treatment on those results. If no results from that time period were available then treatment was done as if GBS status was unknown.
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    GBS has to be between 35-37 weeks gestation, or a rapid GBS obtained at onset of labor, in my neck of the woods.

    Otherwise, we treat prophyactically.
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    We do not treat prophylactically. If a pt is GBS unknown, we do not treat with abx (assuming she's term). I believe that's current evidence-based practice to not treat GBS unknown without the presence of risk factors.
    tablefor9 and Elvish like this.
  6. 0
    The only reason we'd do a GBS on a mom that early is if there were a threatened preterm delivery. If negative, we'd probably retest at 36ish if she's still undelivered. If she comes back +, we'd probably go ahead and treat during labor, whether it occurred at term or before. And if she were a private pt, our private docs would probably treat her in subsequent labors too. I've seen plenty of women with a hx of +GBS be negative with in later pregnancies but that's their current protocol.

    Honestly, though, I can't remember any scenario at my place that mirrors yours. If we have someone come in at term with unknown GBS, we don't treat. Preterm, the scenario changes a bit and it depends as much on who the doc is as anything whether they choose to treat.

    I just attended a webinar on neonatal sepsis and the statistic the presenting neonatologist quoted was that somewhere around 80% of neonatal GBS sepsis cases are from infants whose mothers tested negative. So in the OP scenario it may not be a 'false negative' as much as a later conversion to positive.
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    Thanks for the feedback!
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  9. 1
    I don't know if it is still this way, but a Canadian nurse friend of mine told me that moms who were +GBS did not get treated; rather, they just watched the babies for sepsis. I find that interesting, because for all we know our term unknown GBS moms here are positive as well, and all we do is watch babies x 48hrs, no blood cultures.

    Hopefully someone who works in Canada can clarify this for me.

    My fear is that we treat people so often - and believe me, I understand why -that we are going to eventually end up with GBS that isn't susceptible to any of the current recommended treatment modalities.
    LibraSunCNM likes this.
  10. 2
    Yep, klone, you're right. But, the wheels of change move slowly in OB units in the Deep South...we've only changed from NPO x ICE to clears in labor this last year, in this particular hospital.

    We battle on.
    klone and Elvish like this.
  11. 1
    Quote from tablefor9
    Yep, klone, you're right. But, the wheels of change move slowly in OB units in the Deep South...we've only changed from NPO x ICE to clears in labor this last year, in this particular hospital.

    We battle on.
    Oh, I hear you. Prior to my current job, I worked at a small community hospital with a very strong "Good Ole' Boy" network. The OBs were very old-school and did things their way because that's the way they were taught. Now I work at a very progressive place and there's NO WAY I could ever go back. I would probably get fired for constantly questioning the doctors and pi$$ing them off.
    tablefor9 likes this.


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