Choosing Wisely:

Don’t perform third trimester Group B streptococcus (GBS) culture in patients with GBS bacteriuria during pregnancy.

Rationale and Comments: GBS bacteriuria at levels of 105 CFU/mL or greater, either symptomatic or asymptomatic, warrants acute treatment during pregnancy and indicates the need for intrapartum antibiotic prophylaxis at the time of birth, and thus no additional rectovaginal culture later in pregnancy is necessary. Identification of asymptomatic bacteriuria with GBS during pregnancy at a level less than 105 CFU/mL does not require maternal treatment during the antepartum period but is an indication for intrapartum prophylaxis at the time of birth.
Sponsoring Organizations:
  • Society for Maternal-Fetal Medicine
  • Sources:
  • ACOG guidelines
  • Disciplines:
  • Obstetrical
  • Infectious disease
  • References: • Prevention of Group B streptococcal early-onset disease in newborns: ACOG Committee Opinion, number 797. Obstet Gynecol. 2020;135(2):e51-e72.
    • Allen VM, Yudin MH. Management of group B streptococcal bacteriuria in pregnancy. J Obstet Gynaecol Can. 2018;40:e181-186.
    • Baecher L, Grobman W. Prenatal antibiotic treatment does not decrease group B streptococcus colonization at delivery. Int J Gynaecol Obstet. 2008;101:125-128.

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