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KCE reports vol. 6A Prenatale zorg 104
What are the available interventions for managing women who are GBS carriers and do these interventions improve maternal and perinatal
outcomes?
Study Ref Population Intervention Outcomes Results Comments Study
type
EL
Smail, 4 5 RCTs Intrapartum antibiotics vs. no Infant colonisation with GBS 4 trials (n=624): Peto OR 0.10 No studies used a SR 1a
1999 [444]
treatment
(95%CI 0.07 to 0.14)
placebo or blinded
the observer of the
Early-onset neonatal GBS 4 trials (n=751): Peto OR 0.17 treatment
sepsis
(95%CI 0.07 to 0.39)
allocation
Gibbs
and Mc
Nabb,
1996
Benitz
et al.,
1999
4
[446]
4
[445]
15 patients
admitted in
labour who
had GBS at the
26 to 28 weeks
of gestation
from
December
1993 to August
1994 in the
USA
4 trails on
antibiotics
administered in
5ml of 2% clindamycin cream
intravaginally vs. no treatment
Treatment with broad-spectrum
antibiotics to prevent early-onset
infection and monotherapy to
Neonatal death from
infection
GBS from swabs of distal
vaginal and rectum in mother
GBS in infant from 4 sites
(throat, ear, umbilicus, and
rectum)
Reduced GBS colonisation in
mother and infant delivery
2 trials (n=427): Peto OR 0.12
(95% CI 0.01 to 2.0)
5 of 15 were culture negative at
admission
Treatment group:
5/5 vaginal cultures were positive;
3/5 rectal cultures were positive
2/6 neonates positive at one or
more sites
No treatment group:
¾ positive vaginally and rectally
¼ neonates positive at all four sites
RR (mothers) 1.33 (95%CI 0.76 to
2.35)
RR (infants) 1.33 (95% CI 0.13 to
10.25)
2/4 studies on antepartum
treatment reported reduction in
maternal colonisation at delivery
Computergenerated
randomisation
Literature review
was conducted only
on Medline and
RCT 1b
SR 2a