Hongxia Guo, Wanqiu Huang, Cheng Chen, Bo Sun
Our study shows that cefazolin is effective and safe as penicillin in preventing maternal-fetal GBS infection and may be used as an alternative antibiotics. In addition, it is supposed that IAP should be administered during labor for at least 4h prior to delivery.
PURPOSE: This study aimed to evaluate the effectiveness and safety of cefazolin prophylactic regimen versus standard penicillin treatment in pregnant women colonized with GBS(Group B Streptococcus), and further analyzed the timing of intrapartum antibiotic prophylaxis.
METHOD: We retrospectively analyzed the singleton pregnant women with GBS colonization at 35-37 weeks of gestation in Shenzhen Baoan Women's and Children's Hospital between September 2018 and January 2024. 2653 pregnant women received standardized penicillin prophylaxis and 2418 pregnant women received alternative cefazolin prophylaxis in labor. Maternal and neonatal outcomes were compared between the two different intrapartum antibiotic prophylaxis (IAP) groups.
RESULTS: No significant differences were found in postpartum hemorrhage, amniotic fluid fecal contamination, delivery assistance, neonatal sepsis, neonatal asphyxia and Apgar score between Penicillin group and Cefazolin group (P > 0.05). In terms of chorioamnionitis, neonatal pneumonia, cesarean section, neonatal jaundice and NICU admission, the cefazolin group showed significantly lower rates than that of penicillin group(P < 0.05). The incidence of chorioamnionitis, transfer to cesarean section and NICU admission in both penicillin and cefazolin IAP subgroup of more than 4 h were lower than that of less than or equal 4 h, however with no significantly difference when using cefazolin about chorioamnionitis.
CONCLUSION: Our study shows that cefazolin is effective and safe as penicillin in preventing maternal-fetal GBS infection and may be used as an alternative antibiotics. In addition, it is supposed that IAP should be administered during labor for at least 4h prior to delivery.