The Centers for Disease Control and Prevention (CDC) reported an algorithm for selecting an antibiotic to use for intrapartum prophylaxis against Group B Streptococcus (GBS).
Patient selection: pregnant woman who is a candidate for intrapartum prophylaxis against GBS
(1) allergy to penicillin
(2) history of severe allergic reaction to a penicillin or cephalosporin (angioedema, anaphylaxis, urticaria, respiratory distress)
(3) resistance to clindamycin
(4) resistance to erythromycin or evidence of inducible resistance to clindamycin
Resistance to Clindamycin
penicillin G 5 MU IV initial then 2.5 MU q4h until delivery
ampicillin, 2 g IV initial then 1 g IV q8h until delivery
cefazolin, 2 g IV initial then 1 g IV q 8h until delivery
clindamycin, 900 mg IV q8h until delivery
vancomycin, 1 gram IV q12h until delivery
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Specialty: Infectious Diseases, Pharmacology, clinical, Obstetrics & Gynecology, Pedatrics