Document Detail


Introduction of the new Centers for Disease Control and Prevention group B streptococcal prevention guideline at a large West Coast health maintenance organization.
MedLine Citation:
PMID:  11262460     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Our purpose was to assess the impact of new consensus guidelines issued by the Centers for Disease Control and Prevention, The American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics to prevent perinatal group B streptococcal disease. STUDY DESIGN: We performed a descriptive analysis and a before-and-after analysis of implementation of the group B streptococcal disease prevention guidelines among singleton-birth pregnancies in 2 Group Health Cooperative hospitals from October 1, 1995, through December 31, 1997. We studied the speed and completeness of implementation and the effect on pregnancy care practices including intrapartum antibiotic use, test ordering, and maternal and neonatal health. RESULTS: Guideline implementation occurred rapidly. The proportion of term pregnancies screened according to the guideline increased markedly, and overall intrapartum antibiotic use more than doubled. Among group B streptococci-positive women, intrapartum antibiotic prophylaxis increased from 24% before to 74% after guideline implementation. Median duration of treatment before delivery increased from 1.8 to 4.3 hours. The rate of rash did not increase, and there were no cases of anaphylaxis or pseudomembranous colitis. The proportion of infants undergoing evaluation decreased after implementation of the neonatal guidelines; among infants of group B streptococci-negative women, test ordering dropped by almost 40%. CONCLUSIONS: Implementation of the new guidelines is feasible and can be accomplished rapidly. The guidelines were associated with increased maternal intrapartum antibiotic use, particularly among women at highest risk, and with a decrease in laboratory use for infants.
Authors:
R L Davis; M B Hasselquist; V Cardenas; D M Zerr; J Kramer; A Zavitkovsky; A Schuchat
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  184     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2001 Mar 
Date Detail:
Created Date:  2001-03-23     Completed Date:  2001-04-26     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  603-10     Citation Subset:  AIM; IM    
Affiliation:
Center for Health Studies, the Clinical Planning and Improvement Division, and the Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Seattle, Washington, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Bacterial Agents / therapeutic use
Centers for Disease Control and Prevention (U.S.)*
Female
Gestational Age
Health Maintenance Organizations*
Health Plan Implementation*
Humans
Length of Stay
Mass Screening
Medical Records
Medical Records Systems, Computerized
Practice Guidelines as Topic*
Pregnancy
Streptococcal Infections / diagnosis,  prevention & control*
Streptococcus agalactiae*
United States
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents
Comments/Corrections
Comment In:
Am J Obstet Gynecol. 2002 Feb;186(2):335   [PMID:  11854660 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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