HOME HELP CONTACT US FEEDBACK SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Résumé Full Text Full Text (PDF) Rapid Responses: Submit a response Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Konrad, G. Articles by Pylypjuk, C. Search for Related Content PubMed Articles by Konrad, G. Articles by Pylypjuk, C.

Prevention of neonatal group B streptococcal infection

Approaches of physicians in Winnipeg, Man

Susan Hauch, MD CCFP
Associate Professor in the Department of Family Medicine at the University of Manitoba and is on faculty of the University of Manitoba Family Medicine Residency Program where she is Director of Undergraduate Education.

Christy Pylypjuk
Medical student enrolled in the Faculty of Medicine at the University of Manitoba

Correspondence to: Dr Gerald Konrad, Family Medicine Centre, 400 Tache Ave, Winnipeg, MB M2H 3E1; telephone 204 237-2863; fax 204 231-2648; e-mail gkonrad{at}sbgh.mb.ca

OBJECTIVE To determine how family physicians in Winnipeg, Man, approach prevention of neonatal group B streptococcal (GBS) infection, what influences their decisions, and whether their decisions differ from those of local obstetricians.

DESIGN Population-based survey.

SETTING Family physicians’ and obstetricians’ practices in Winnipeg.

PARTICIPANTS Eighty-five physicians and residents with hospital labour floor privileges.

MAIN OUTCOME MEASURES Individual approaches to prevention of neonatal GBS infection, factors influencing choice of approach, and perceptions of neonatal GBS disease and universal prenatal GBS screening.

RESULTS About 66% of family physicians and their residents followed the Society of Obstetricians and Gynaecologists of Canada’s (SOGC) guidelines for universal GBS screening and intrapartum antibiotic prophylaxis of all GBS carriers. This was significantly fewer than the 87% of obstetricians who followed these guidelines (P = .026). Obstetricians were more likely than family physicians to cite the literature as influencing their approach to neonatal GBS prevention (P < .001). Family physicians were more likely to cite the influence of peers and colleagues (P = .04). The incidence of neonatal GBS and its associated mortality were overestimated by 61% and 55% of obstetricians, and 66% and 57% of family physicians, respectively. Despite concerns about the risks and costs of universal GBS screening and intrapartum antibiotic prophylaxis, 92% of obstetricians and 79% of family physicians thought that the benefits of universal screening outweighed the concerns. About 24% of obstetricians and 30% of family physicians were theoretically willing to expose more than 10 000 women to intrapartum prophylactic antibiotics to prevent a single neonatal GBS-related death.

CONCLUSION Family physicians were less likely than obstetricians to follow current SOGC guidelines for prevention of neonatal GBS disease. This could reflect adifferent perspective on patient care. Family physicians want patients to be involved in screening decisions based on full disclosure of potential harm and benefit.