Compliance with a risk-factor-based guideline for the prevention of neonatal group B streptococcal sepsis
✍ Scribed by Maureen T. Fleming; Robert S. McDuffie Jr; Kathy Russell; Susan Meikle
- Publisher
- Hindawi Publishing Corporation
- Year
- 1997
- Tongue
- English
- Weight
- 48 KB
- Volume
- 5
- Category
- Article
- ISSN
- 1064-7449
No coin nor oath required. For personal study only.
✦ Synopsis
Objective: The purpose of this study was to determine the compliance rate with a maternal riskfactor-based guideline for the prevention of neonatal group B streptococcal (GBS) sepsis.
Methods: In August 1994, a risk-factor-based guideline for selective intrapartum prophylaxis against neonatal GBS was adopted by a group model health maintenance organization. This guideline identified the following maternal risk factors for neonatal GBS sepsis: preterm delivery, rupture of membranes for >18 h, fever/chorioamnionitis, and history of a previous GBS-affected child. Patients with one or more risk factors were to receive intrapartum antibiotic prophylaxis consisting of either ampicillin, erythromycin, or clindamycin. We conducted a retrospective chart review to record risk factors and use of antibiotics. We hypothesized that >90% of patients with risk factors would receive intrapartum chemoprophylaxis.
Results: A total of 805 maternal charts were reviewed. Of these, 105 (13%) were candidates for intrapartum prophylaxis. We found an overall compliance rate of 65%. Compliance rates by risk factor were preterm delivery (51%), prolonged rupture of membranes (73%), fever/chorioamnionitis (87%), and previous affected child (100%).
Conclusions: Our results show unexpectedly low compliance rates with a risk-factor-based guideline for the prevention of neonatal GBS sepsis. Only 65% of women with any risk factor for neonatal GBS sepsis received intrapartum antibiotic prophylaxis appropriately. Educational efforts to improve compliance with a risk-factor-based guideline should specifically address mothers delivering at 34-36 weeks gestation and mothers with prolonged rupture of membranes.