From the Guidelines
Cefixime is not the preferred antibiotic for treating Group B Streptococcus (GBS) urinary tract infections. While cefixime has some activity against GBS, penicillins and other beta-lactam antibiotics are more effective first-line treatments 1. For GBS urinary tract infections, the recommended antibiotics include penicillin G, ampicillin, or amoxicillin. In cases of penicillin allergy, clindamycin or vancomycin may be used as alternatives.
Key Points to Consider
- GBS remains highly susceptible to penicillins because these antibiotics target the bacterial cell wall synthesis effectively 1.
- Cefixime, while a third-generation cephalosporin with good gram-negative coverage, does not provide optimal coverage for GBS compared to these first-line options.
- When treating GBS infections, it's essential to complete the full course of antibiotics even if symptoms improve before completion to ensure complete eradication of the bacteria and prevent recurrence.
Treatment Recommendations
- The typical treatment duration for GBS urinary tract infections is 7-10 days.
- Women with GBS bacteriuria in any concentration during their current pregnancy or who previously gave birth to an infant with GBS disease should receive intrapartum antimicrobial prophylaxis 1.
- In the absence of GBS urinary tract infection, antimicrobial agents should not be used before the intrapartum period to treat asymptomatic GBS colonization 1.
From the Research
Cefixime Coverage for Group B Streptococcus Urine Infection
- The provided studies do not directly address the effectiveness of cefixime against group B streptococcus (GBS) urine infections 2, 3, 4, 5, 6.
- However, study 2 discusses the susceptibility of GBS to various antibiotics, including cefotaxime and ceftriaxone, which are related to cefixime.
- Study 3 and 4 report on the efficacy of cefixime in treating urinary tract infections (UTIs), but do not specifically mention GBS as a causative agent.
- Study 6 characterizes the serotypes of GBS causing UTIs in adults, but does not discuss the effectiveness of cefixime against these infections.
- Based on the available information, it is unclear whether cefixime is effective against GBS urine infections, and more research is needed to determine its coverage for this specific type of infection.
Antibiotic Susceptibility of Group B Streptococcus
- Study 2 found that some GBS isolates were non-susceptible to cefotaxime and ceftriaxone, which may indicate a potential limitation in the use of cefixime against GBS infections 2.
- Study 6 reports on the antibiotic susceptibility of GBS isolates from UTIs, including resistance to erythromycin and clindamycin, but does not provide information on cefixime susceptibility 6.