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Intrapartum Antibiotic Chemoprophylaxis Policies for the Prevention of Group B Streptococcal Disease Worldwide: Systematic Review.

Le Doare, K; O'Driscoll, M; Turner, K; Seedat, F; Russell, NJ; Seale, AC; Heath, PT; Lawn, JE; Baker, CJ; Bartlett, L; et al. Le Doare, K; O'Driscoll, M; Turner, K; Seedat, F; Russell, NJ; Seale, AC; Heath, PT; Lawn, JE; Baker, CJ; Bartlett, L; Cutland, C; Gravett, MG; Ip, M; Madhi, SA; Rubens, CE; Saha, SK; Schrag, S; Sobanjo-Ter Meulen, A; Vekemans, J; Kampmann, B; GBS Intrapartum Antibiotic Investigator Group, (2017) Intrapartum Antibiotic Chemoprophylaxis Policies for the Prevention of Group B Streptococcal Disease Worldwide: Systematic Review. Clin Infect Dis, 65 (suppl_2). S143-S151. ISSN 1537-6591 https://doi.org/10.1093/cid/cix654
SGUL Authors: Heath, Paul Trafford

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Abstract

Background: Intrapartum antibiotic chemoprophylaxis (IAP) prevents most early-onset group B streptococcal (GBS) disease. However, there is no description of how IAP is used around the world. This article is the sixth in a series estimating the burden of GBS disease. Here we aimed to review GBS screening policies and IAP implementation worldwide. Methods: We identified data through (1) systematic literature reviews (PubMed/Medline, Embase, Literature in the Health Sciences in Latin America and the Caribbean [LILACS], World Health Organization library database [WHOLIS], and Scopus) and unpublished data from professional societies and (2) an online survey and searches of policies from medical societies and professionals. We included data on whether an IAP policy was in use, and if so whether it was based on microbiological or clinical risk factors and how these were applied, as well as the estimated coverage (percentage of women receiving IAP where indicated). Results: We received policy information from 95 of 195 (49%) countries. Of these, 60 of 95 (63%) had an IAP policy; 35 of 60 (58%) used microbiological screening, 25 of 60 (42%) used clinical risk factors. Two of 15 (13%) low-income, 4 of 16 (25%) lower-middle-income, 14 of 20 (70%) upper-middle-income, and 40 of 44 (91%) high-income countries had any IAP policy. The remaining 35 of 95 (37%) had no national policy (25/33 from low-income and lower-middle-income countries). Coverage varied considerably; for microbiological screening, median coverage was 80% (range, 20%-95%); for clinical risk factor-based screening, coverage was 29% (range, 10%-50%). Although there were differences in the microbiological screening methods employed, the individual clinical risk factors used were similar. Conclusions: There is considerable heterogeneity in IAP screening policies and coverage worldwide. Alternative global strategies, such as maternal vaccination, are needed to enhance the scope of global prevention of GBS disease.

Item Type: Article
Additional Information: © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: group B Streptococcus, intrapartum antibiotic chemoprophylaxis, Microbiology, 06 Biological Sciences, 11 Medical And Health Sciences
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: Clin Infect Dis
ISSN: 1537-6591
Language: eng
Dates:
DateEvent
15 November 2017Published
6 November 2017Published Online
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
OPP1131158Bill and Melinda Gates Foundationhttp://dx.doi.org/10.13039/100000865
PubMed ID: 29117324
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/109301
Publisher's version: https://doi.org/10.1093/cid/cix654

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