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RMJ. 2015; 40(1): 81-83

Study to identify and rectify the causes of failure to administer Intra partum antibiotic prophylaxis in Group B streptococcus positive mothers and itís effect on fetal outcome

Jahan Ara Saeed.

Objective: To perform an audit to review and minimize the reasons of failure to administer Intrapartum antibiotic prophylaxis [IAP] to all GBS positive mothers who presented in labor and itís effect on fetal outcome.
Methodology: A review of all the electronic charts at Tawam Hospital during a 6 month period from 6th April till 6th October 2009. It included women who presented in labor with a GBS positive status who needed to receive IAP and their babies blood cultures were performed postnatal.
Results: There were 2405 deliveries during this period. Two hundred and nine cases were GBS positive. IAP was given only to 48 patients i.e 23% while 161 (77%) did not receive any treatment. The various reasons documented were patient presented late in active labor were 59%. Medication [Penicillin] was ordered but delayed from pharmacy. Penicillin ordered late or not ordered by the doctor in 14% and 1% were the patients who underwent elective c-section. All the babies had no growth of GBS with blood culture postnatal.
Conclusion: The various strategies to improve the rate of administration of IAP which have been discussed above including patient education, patient information leaflet, physician order from antenatal clinic and midwife ordering the IAP need to be addressed and implement a new guideline .

Key words: Group B streptococcus [GBS], Intra partum antibiotic prophylaxis [IAP], Early onset group B streptococcus [EOGBS], Cesarean section.

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