Group B Strep guidelines: Key points for health professionals

Updated Group B Strep Guidelines Key points for health professionals compiled by Group B Strep Support

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Updated Group B Strep Guidelines Key points for health professionals Group B Streptococcus (GBS or group B Strep) is the most common cause of severe infection in newborn babies, and of meningitis in babies under age 3 months. On average in the UK: • 2 babies a day develop group B Strep infection • 1 baby a week dies from group B Strep infection • 1 baby a week survives group B Strep infection with long term disability 0RVW *%6 LQIHFWLRQ LV RI HDUO\ RQVHW SUHVHQWLQJ LQ EDELHV ZLWKLQ WKH ÀUVW GD\V RI OLIH DQG XVXDOO\ ZLWKLQ WKH ÀUVW KRXUV DIWHU ELUWK %HWZHHQ DJH days and 3 months, these infections are rare, and in babies over after age 3 months they are very rare indeed.

0RVW HDUO\ RQVHW *%6 LQIHFWLRQV LQ EDELHV DJHG GD\V FDQ EH prevented by giving intravenous antibiotics in labour to women whose babies are at raised risk of developing GBS infection. In the UK, women DUH RIIHUHG ,9 DQWLELRWLFV LQ ODERXU LV EDVHG RQ VSHFLÀF ULVN IDFWRUV The Royal College of Obstetricians and Gynaecologists (RCOG) published a major update to their clinical guideline on preventing group B Strep LQIHFWLRQ WKHLU *UHHQ WRS *XLGHOLQH *7* 1R 1 RQ 6HSWHPEHU There are substantial changes from the previous edition, published in DQG WKLV OHDÁHW VXPPDULVHV WKH NH\ UHFRPPHQGDWLRQV New recommendations are in italics, and the GTG paragraph numbers are given in brackets.

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1. What should you do during a woman’s pregnancy?

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• Treating GBS found on a vaginal or rectal swab is not recommended in pregnancy before labour starts.

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2. Who should be offered antibiotics in labour?

Women should be offered antibiotics effective against GBS in labour who:

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The full Green-top guideline is free to download from: ZZZ UFRJ RUJ XN HQ JXLGHOLQHV UHVHDUFK VHUYLFHV JXLGHOLQHV JWJ

Key recommendations from Royal College of Obstetricians & Gynaecologists’ 2017 Prevention of Early-onset Neonatal Group B Streptococcal (GBS) Disease Green-top Guideline No 36

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BABY BORN

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IAP = Intrapartum Antimicrobial Prophylaxis Benzyl Penicillin recommended.

If penicillin-allergic, a cephalosporin.

If severely allergic, vancomycin.

Clindamycin not recommended.

Offer ASAP once labour has started.

BABY WITH SIGN(S) OF EOGBS INFECTION

NICE CG149, point 1.2.3.1: TREAT BABY WITH 3(1,&,//,1 $1' GENTAMICIN WITHIN AN HOUR OF '(&,6,21 72 75($7

“If there are any risk factors for early-onset neonatal infection or if there are clinical indicators of possible early-onset neonatal infection perform a careful clinical assessment without delay.

Review the maternal and neonatal history and carry out a physical examination of the baby including an assessment of vital signs.”

The full Green-top guideline is free to download from: ZZZ UFRJ RUJ XN HQ JXLGHOLQHV UHVHDUFK VHUYLFHV JXLGHOLQHV JWJ

4. Which IV antibiotic should I use?

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5. What happens around labour and delivery?

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7. Signs of GBS infection to look out for in a newborn baby: )DPLOLHV VKRXOG EH HQFRXUDJHG WR VHHN XUJHQW PHGLFDO DWWHQWLRQ LI WKHLU EDE\ *7*

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The full Green-top guideline is free to download from: ZZZ UFRJ RUJ XN HQ JXLGHOLQHV UHVHDUFK VHUYLFHV JXLGHOLQHV JWJ

8. What do I do next?

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• If women who want to test for GBS carriage during pregnancy are unable to access an ECM test in your Trust, signpost them to ZZZ JEVV RUJ XN WHVW IRU VXSSOLHUV WKDW IROORZ 3+(·V 8. 60, % &RVW IURP XQGHU IRU KRPH WHVWLQJ SDFN DQG UHSRUWLQJ

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Sources and acknowledgements 7KH LQIRUPDWLRQ LQ WKLV OHDÁHW LV EDVHG RQ 5&2* *UHHQ²WRS *XLGHOLQH 1R Prevention of Early-onset Neonatal Group B 6WUHSWRFRFFDO 'LVHDVH

Charity Group B Strep Support was founded in 1996, with the over-arching objective of preventing group B Strep infection in newborn babies. We support families affected by group B Strep, educate health professionals and the public about group B Strep, and support research into better understanding of group B Strep infection.

Get the facts and get involved at: Search Group B Strep Support

www.gbss.org.uk

7HO #GBSaware

0330 120 0796

www.gbss.org.uk

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