This activity is intended for healthcare providers delivering care to women and their families.
After completing this activity, the participant should be better able to:
1. Recall antibiotic choices for patients who are not allergic to penicillin
2. List antibiotics that may be used in the setting of penicillin allergy
Estimated time to complete activity: 0.25 hours
Susan J. Gross, MD, FRCSC, FACOG, FACMG
President and CEO, The ObG Project
Postgraduate Institute for Medicine (PIM) requires faculty, planners, and others in control of educational content to disclose all their financial relationships with ineligible companies. All identified conflicts of interest (COI) are thoroughly vetted and mitigated according to PIM policy. PIM is committed to providing its learners with high quality accredited continuing education activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of an ineligible company.
The PIM planners and others have nothing to disclose. The OBG Project planners and others have nothing to disclose.
Faculty: Susan J. Gross, MD, receives consulting fees from Cradle Genomics, and has financial interest in The ObG Project, Inc.
Planners and Managers: The PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN, and Jan Schultz, MSN, RN, CHCP have nothing to disclose.
Fees for participating and receiving CME credit for this activity are as posted on The ObG Project website. During the period from 1/25/2022 through 1/25/2024, participants must read the learning objectives and faculty disclosures and study the educational activity.
If you wish to receive acknowledgment for completing this activity, please complete the test and evaluation. Upon registering and successfully completing the test with a score of 100% and the activity evaluation, your certificate will be made available immediately.
In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and The ObG Project. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Postgraduate Institute for Medicine designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The maximum number of hours awarded for this Continuing Nursing Education activity is 0.2 contact hours.
Designated for 0.1 contact hours of pharmacotherapy credit for Advance Practice Registered Nurses.
Group B streptococcal (GBS) disease remains a leading cause of early-onset neonatal sepsis in the US. The ACOG committee opinion has been endorsed by the AAP, ACNM, AWHONN and SMFM. Furthermore, CDC states that the ACOG committee opinion supersedes the 2010 CDC recommendations.
Updates to note:
…if available, is safe during pregnancy and can be beneficial for all women who report a penicillin allergy, particularly those that are suggestive of being IGE mediated, or of unknown severity, or both.
Pregnant women should undergo vaginal-rectal screening for GBS colonization at 36w0d – 37w6d (screening valid up to at least 41w0d)
Intrapartum antibiotic prophylaxis is recommended for women
Note: (1) Penicillin remains the preferred agent with ampicillin an acceptable alternative; (2) Clinicians do not need to test women who had a previous baby who developed GBS disease – These women should receive antibiotics (see above)
NO – not allergic to penicillin
YES! – is allergic to penicillin
Low risk for anaphylaxis: History of any of the following after receiving penicillin or a cephalosporin
High risk for anaphylaxis: History of any of the following after receiving penicillin or a cephalosporin
Note: Vancomycin: Max single dose is 2 g | Minimum infusion time of 1 hour (500 mg/30 minutes) for a dose >1 g
Risk Unknown – options include
Possible preterm labor
Preterm labor no longer imminent
Note: ACOG notes that there are different standards internationally: For example, RCOG recommends GBS culture 3 to 5 weeks prior to anticipated delivery date for high risk pregnancy, otherwise at 35-37 weeks gestation for uncomplicated pregnancies (see ‘Learn More – Primary Sources’ below for RCOG standards)
Obtain GBS culture and Start latency antibiotics (that cover GBS)
Note: Induction recommended for PPROM ≥34w0d, although some women may wish to delay in order to enter spontaneous labor | If patient is GBS positive, expectant management should be discouraged
ACOG Committee Opinion 797: Prevention of Group B Streptococcal Early-Onset Disease in Newborns
RCOG Green Top Guideline 36: Prevention of Early‐onset Neonatal Group B Streptococcal Disease
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This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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