Indications for Maternal IAP

<p>Antibiotic prophylaxis not indicated — It is reasonable to avoid intrapartum antibiotic prophylaxis in the following settings:

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<ul>

<li>Positive GBS culture in a previous pregnancy, but no neonatal GBS infection and a recent negative screening culture in the current pregnancy</li>

<li>Women with a positive GBS culture who undergo planned cesarean delivery without labor or rupture of membranes</li>

<li>Pregnant women with negative GBS cultures at 35 to 37 weeks of gestation even if they have one or more of the following intrapartum risk factors: intrapartum fever (≥100.4ºF, ≥38ºC), preterm labor (&#60;37 weeks of gestation), or prolonged rupture of membranes (≥18 hours). However, the use of broad-spectrum intrapartum antibiotics for the treatment (not prophylaxis) is indicated for febrile women in labor if they have clinical evidence of chorioamnionitis.</li>

</ul>

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Exposure to broad-spectrum intrapartum antibiotic prophylaxis has been associated with an increased risk of late-onset serious bacterial infections and infection with resistant organisms. These findings support the recommendation to use penicillin as the preferred agent for GBS prophylaxis, rather than broader spectrum antibiotics, such as ampicillin.</p>