From the Guidelines
Augmentin is not the recommended first-line treatment for Group B Streptococcus (GBS) according to the most recent guidelines. The Centers for Disease Control and Prevention (CDC) recommends penicillin G or ampicillin as the first-line treatment for GBS prophylaxis in pregnant women 1. Augmentin, which combines amoxicillin with clavulanic acid, may not be the most effective choice for GBS prophylaxis due to its broader spectrum of activity, which may not be necessary for GBS treatment.
Key Points to Consider
- Penicillin G or ampicillin are the preferred agents for GBS prophylaxis in pregnant women, as they have a narrower spectrum of antimicrobial activity and are highly effective against GBS 1.
- Augmentin may be considered for treatment of complicated infections or mixed infections where other bacteria are present alongside GBS, but it is not the first-line treatment for GBS prophylaxis.
- Patients with penicillin allergies should inform their healthcare provider, as alternative antibiotics such as cefazolin, vancomycin, or clindamycin may be necessary 1.
Treatment Recommendations
- For GBS prophylaxis in pregnant women, penicillin G or ampicillin are the recommended first-line treatments, with dosages aimed at achieving adequate levels in the fetal circulation and amniotic fluid rapidly while avoiding potentially neurotoxic serum levels in the mother or fetus 1.
- Augmentin may be considered for treatment of complicated infections or mixed infections, but its use should be guided by the specific clinical scenario and susceptibility testing results.
From the Research
Antibiotic Coverage for Group B Streptococcus (GBS)
- Augmentin, a combination of amoxicillin and clavulanic acid, is not explicitly mentioned in the provided studies as a recommended treatment for GBS.
- The studies suggest that penicillin, ampicillin, or cefazolin are recommended for prophylaxis against GBS 2, 3.
- Clindamycin and vancomycin are reserved for cases of significant maternal penicillin allergy 2, 4, 3.
- GBS isolates have shown resistance to various antibiotics, including erythromycin, clindamycin, and fluoroquinolones 4, 5, 3, 6.
- The American Academy of Pediatrics and the American College of Obstetricians and Gynecologists recommend maternal intrapartum antibiotic prophylaxis based on antenatal screening for GBS colonization 2.
Antibiotic Resistance Patterns
- GBS isolates have exhibited reduced susceptibility to beta-lactam antibiotics, including penicillin, in some countries 5.
- Resistance to second-line antibiotics, such as erythromycin and clindamycin, remains high amongst GBS 5, 3, 6.
- Vancomycin is administered in instances where patients are allergic to penicillin and second-line antibiotics are ineffective, although there have been two documented cases of vancomycin resistance in GBS 5.