Adult
Intra-partum prophylaxis for group B streptococcus (GBS)
Indicated for pregnant women in labour with any of the following:
- Prolonged rupture of membranes (longer than 24 hours)
- Preterm (less than 37 weeks) pre-labour rupture of membranes
- Previous pregnancy with GBS infection including previous neonate with confirmed early-onset GBS infection
- Known carrier of GBS*
*GBS colonisation detected on a vaginal swab at any time during the current pregnancy, either through an incidental swab or through the targeted GBS screening pathway or GBS bacteriuria detected at any time during the current pregnancy
Preferred
benzylpenicillin 3g iv single dose, then 1.5g iv 4hourly until delivery
Alternative
Penicillin allergy (non-severe): cefazolin iv (see initial dosing table below), then 1g 8-hourly until delivery (max 6g/day)
| cefazolin iv dose | |
| Weight under 50kg | 1g |
| Weight 50kg to less than 120kg | 2g |
| Weight 120kg or more | 3g |
| Creatinine Clearance less than 10ml/min or patient receiving Haemodialysis | 1g |
Penicillin allergy (severe):
clindamycin 900mg iv tds until delivery - ONLY if GBS has been isolated and KNOWN to be susceptible
OR vancomycin IV as per protocol