Pre-vaginal delivery antibiotic prophylaxis: common practice and controversy

Group B Streptococcus GBS sporadically colonizes the vagina and rectum of approximately onequarter of pregnant women. It is the most common cause of neonatal sepsis, with an incidence of
0.29-0.39 cases per 1000 live births. There is a lack of consensus regarding screening and
management of GBS among professional societies. Certain societies such as the American College of
Obstetrics and Gynecology advocate mandatory screening as well as intrapartum antibiotic
prophylaxis, while other societies such as the Royal College of Obstetricians and Gynaecologists
deemed screening futile and costly as colonization is intermittent by nature. This review examines the
current practice and controversy surrounding GBS screening and management as well as the benefits
and harms of intrapartum antibiotic prophylaxis prior to vaginal delivery.