In labor, when is intrapartum antibiotics recommended for GBS during labor?

• A. Only in cases of symptomatic infection
• B. Only after delivery
• C. If positive GBS status or unknown with risk factors
• D. If NSAIDs used

Answer: (C)

The main idea is preventing newborn infection by giving antibiotics during labor to a mother who carries Group B Streptococcus. The best choice is to administer intrapartum antibiotics when GBS status is positive or when it’s unknown but risk factors are present, because these situations mean the baby could be exposed to the bacteria during birth. Treating at the onset of labor or after the membranes have ruptured reduces the risk of early-onset GBS disease in the newborn, which is most dangerous in the first days of life. The standard approach is IV penicillin G (or an alternative if there’s a allergy) started during labor and continued until delivery. Risk factors include a history of a prior infant with GBS disease, GBS bacteriuria in the current pregnancy, rupture of membranes for more than 18 hours, preterm labor (<37 weeks), and intrapartum fever. If GBS status is negative and there are no risk factors, routine intrapartum antibiotics aren’t indicated. NSAID use has no relation to GBS prophylaxis.