Division of Research, Department of Obstetrics and Gynecology, Women and Infants Hospital, The Warren Alpert Medical School at Brown University, Providence, RI, USA.
Am J Obstet Gynecol. 2011 Feb;204(2):150.e1-8. doi: 10.1016/j.ajog.2010.08.063. Epub 2010 Dec 17.
The purpose of this study was to compare adherence to the 2002 Centers for Disease Control (CDC) guidelines for the prevention of perinatal group B Streptococcus (GBS) disease in patients who are allergic to penicillin during the years 2004-2006 and 2008.
Previous data from our institution revealed suboptimal adherence to the 2002 CDC guidelines for GBS prophylaxis among women who are allergic to penicillin. These data caused the hospital to implement a series of interventions. The original cohort (2004-2006) was compared with a cohort of women who delivered between April 2008 and January 2009 (n = 74) to determine whether the proportion of women who had antimicrobial sensitivity testing and who had received an appropriate antibiotic had improved.
In 2008, 76% (95% confidence interval, 66-84%) of GBS-positive women who are allergic to penicillin received an appropriate antibiotic (compared with 16.2% in 2004-2006; P < .001). Antimicrobial sensitivity testing was performed in 79.4% of cases (95% confidence interval, 68-87%), compared with 11.4% in 2004-2006 (P < .001).
With directed intervention, adherence to the 2002 CDC guidelines for GBS prophylaxis in women who are allergic to penicillin improved dramatically.
本研究旨在比较 2004-2006 年和 2008 年对青霉素过敏的患者在预防围产期 B 组链球菌（GBS）疾病方面对 2002 年疾病控制与预防中心（CDC）指南的依从性。
我们机构之前的数据显示，对青霉素过敏的妇女在 GBS 预防方面对 2002 年 CDC 指南的依从性并不理想。这些数据促使医院实施了一系列干预措施。将原始队列（2004-2006 年）与 2008 年 4 月至 2009 年 1 月之间分娩的女性队列（n=74）进行比较，以确定接受抗生素敏感性检测和接受适当抗生素治疗的女性比例是否有所提高。
2008 年，76%（95%置信区间，66-84%）对青霉素过敏的 GBS 阳性女性接受了适当的抗生素治疗（与 2004-2006 年的 16.2%相比；P<.001）。79.4%（95%置信区间，68-87%）的病例进行了抗生素敏感性检测，而 2004-2006 年为 11.4%（P<.001）。
通过有针对性的干预，对青霉素过敏的女性遵循 2002 年 CDC 指南进行 GBS 预防的依从性显著提高。
