What is the treatment for group B strep?
For women who test positive for GBS during pregnancy and for those with certain risk factors for developing or transmitting GBS infection during pregnancy, intravenous antibiotics are recommended at the time of labor. The administration of antibiotics to women before labor who are known to be colonized with GBS is not effective in preventing early onset disease, as it has been found that the GBS bacteria can grow back quickly. Pregnant women with GBS isolated from the urine at any time during the pregnancy and those women who have had a previous infant with invasive GBS infection should receive antibiotics during labor, and thereby do not require the routine GBS screening at 35-37 weeks of gestation. Pregnant women who are not aware of their group B strep status should be given antibiotics during labor if they develop preterm labor (less than 37 weeks gestation), if they have membrane rupture for 18 hours or longer, or if they develop fever during labor. Penicillin or ampicillin are the recommended antibiotics, while individuals who are penicillin-allergic may be given either cefazolin, clindamycin, or vancomycin. The administration of antibiotics has been shown to significantly decrease GBS early onset infection in newborns; however, it does not prevent late onset GBS infection. If a pregnant carrier of GBS receives intravenous antibiotics during delivery, her baby has a one in 4,000 chance of developing GBS infection. Without antibiotics, her baby has a one in 200 chance of developing GBS infection.
In neonates and nonpregnant adults who develop invasive group B streptococcal disease, intravenous antibiotics are also the mainstay of treatment. There are certain conditions associated with invasive GBS infection that may require surgical intervention, for example surgical debridement in certain patients with soft tissue/skin/bone infections.