Portal de Periódicos da CAPES

Intrapartum Antibiotic Chemoprophylaxis Policies for the Prevention of Group B Streptococcal Disease Worldwide: Systematic Review

2017; Oxford University Press; Volume: 65; Issue: suppl_2 Linguagem: Inglês

10.1093/cid/cix654

1537-6591

Kirsty Le Doaré, Megan O’Driscoll, Kim Turner, Farah Seedat, Neal Russell, Anna C. Seale, Paul T. Heath, Joy E. Lawn, Carol J. Baker, Linda Bartlett, Clare Cutland, Michael G. Gravett, Margaret Ip, Shabir A. Madhi, Craig E. Rubens, Samir K. Saha, Stephanie J. Schrag, Ajoke Sobanjo-ter Meulen, Johan Vekemans, Beate Kampmann, A Ramoni, Rikke Bek Helmig, Kaarin Mäkikallio, Tengiz Asatiani, M. Bruce Fisher, Michael Feinstein, Yuval Oz, Matan Elami Suzin, Vered H. Eisenberg, Alberto Berardi, Indi Trehan, Georgia Leigh Macad, Miha Lučovnik, Claire Oluwalana, Pippa Letchworth, Martin Jagoutz-Herzlinger, Francis G. Muriithi, Kouther Issa Yassen, Gerard H.A. Visser, Sophie Cooper,

Pneumonia and Respiratory Infections

Intrapartum antibiotic chemoprophylaxis (IAP) prevents most early-onset group B streptococcal (GBS) disease. However, there is no description of how IAP is used around the world. This article is the sixth in a series estimating the burden of GBS disease. Here we aimed to review GBS screening policies and IAP implementation worldwide. We identified data through (1) systematic literature reviews (PubMed/Medline, Embase, Literature in the Health Sciences in Latin America and the Caribbean [LILACS], World Health Organization library database [WHOLIS], and Scopus) and unpublished data from professional societies and (2) an online survey and searches of policies from medical societies and professionals. We included data on whether an IAP policy was in use, and if so whether it was based on microbiological or clinical risk factors and how these were applied, as well as the estimated coverage (percentage of women receiving IAP where indicated). We received policy information from 95 of 195 (49%) countries. Of these, 60 of 95 (63%) had an IAP policy; 35 of 60 (58%) used microbiological screening, 25 of 60 (42%) used clinical risk factors. Two of 15 (13%) low-income, 4 of 16 (25%) lower-middle–income, 14 of 20 (70%) upper-middle–income, and 40 of 44 (91%) high-income countries had any IAP policy. The remaining 35 of 95 (37%) had no national policy (25/33 from low-income and lower-middle–income countries). Coverage varied considerably; for microbiological screening, median coverage was 80% (range, 20%–95%); for clinical risk factor–based screening, coverage was 29% (range, 10%–50%). Although there were differences in the microbiological screening methods employed, the individual clinical risk factors used were similar. There is considerable heterogeneity in IAP screening policies and coverage worldwide. Alternative global strategies, such as maternal vaccination, are needed to enhance the scope of global prevention of GBS disease.