4053.0: Tuesday, November 14, 2000 - 8:45 AM

Abstract #3723

Clinician Compliance with Group B Streptococcal Disease Prevention Guidelines

Latha Chandran, MD1, Maryam Navaie-Waliser, Dr.P.H2, Naz J. Zulqarni, MD3, Sandeep Batra, MD4, Hulya Bayir, MD5, and Michelle Shah, BS1. (1) Department of Pediatrics, State University of New York at Stony Brook, Health Sciences Center, Level 11, Rm 080, School of Medicine, Stony Brook, NY 11794-8111, (2) Center for Home Care Policy and Research, Visiting Nurse Service of New York, 5 Penn Plaza, 18th Floor, New York, NY 10001-1810, 212-290-3549, mnavaie@vnsny.org, (3) Department of Pediatrics, Texas Tech University Medical Center, Amarillo, TX, (4) Department of Hematology, Children's Hospital, Los Angeles, CA, (5) Department of Pediatrics, Children's Hospital, Pittsburgh, PA

This study assessed the degree of clinician compliance with nationally recommended guidelines for the prevention of early onset Group B Streptococcal (GBS) disease in infants. A secondary objective was to identify areas for specific educational interventions to enhance clinician compliance. A prospective cohort study was undertaken at a tertiary medical center in New York. Mothers (n=515) with any known risk factor for GBS sepsis who delivered live births (n=537) in a nine-month study period participated. No interventions were done. Compliance of obstetric and pediatric clinicians with nationally recommended management algorithms for pregnant women and infants at risk for GBS disease was evaluated. The results revealed that in the combined risk factor and culture-based algorithm for maternal management, clinician compliance with administration of intrapartum antibiotic prophylaxis, when indicated, was between 75% to 84%. Unindicated antibiotics were administered in 22% of the women. Among the women for whom antenatal cultures were indicated, 65% received it. Only 9% of the cultures were performed from the anogenital site, as recommended. In the risk factor-based maternal management algorithm, indicated antibiotics were administered to 76% of the women and unindicated antibiotics to 15% of the women. Use of penicillin, the recommended antibiotic, ranged between 0% to 9%. Among the infants, between 14% to 75% received recommended evaluations and 61% to 94% were observed for at least 48 hours after discharge. Clinician compliance with current GBS disease prevention guidelines for mothers and infants is fair. Targeted education efforts may improve compliance.

Learning Objectives: At the end of this session, participants will be able to: 1. List the recommended maternal and infant management guidelines for the prevention of early onset of GBS disease; 2. Discuss the need for clinician education pertaining to the higher yield for GBS detection via site specific cultures and the importance of limiting the use of broad spectrum antibiotics; 3. Recognize that medical centers could facilitate compliance with nationally recommended guidelines by establishing specific policies for the detection and treatment of early onset of GBS disease

Keywords: Disease Management, Maternal and Child Health

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA