From the Guidelines
No, Rocephin (ceftriaxone) is not the preferred choice for Group B Streptococcus (GBS) coverage. According to the revised guidelines from the CDC in 2010 1, the recommended regimens for intrapartum antibiotic prophylaxis for prevention of early-onset group B streptococcal (GBS) disease include penicillin G, ampicillin, cefazolin, vancomycin, and clindamycin, but not Rocephin.
Key Points to Consider
- For patients who are not allergic to penicillin, penicillin G or ampicillin are the preferred choices for GBS prophylaxis 1.
- For patients who are allergic to penicillin, cefazolin is the preferred agent if they do not have a history of anaphylaxis, angioedema, respiratory distress, or urticaria following administration of penicillin or a cephalosporin 1.
- Vancomycin and clindamycin are reserved for penicillin-allergic women at high risk for anaphylaxis 1.
Clinical Implications
It is essential to note that while Rocephin may have activity against GBS, it is not the recommended choice for GBS prophylaxis during labor, and other antibiotics should be used as first-line options. The choice of antibiotic should be guided by the patient's allergy history and the susceptibility of the GBS isolate, if available 1.
From the Research
Group B Strep and Rocephin Coverage
- Rocephin, also known as ceftriaxone, is a cephalosporin antibiotic that is effective against Group B Streptococcus (GBS) 2, 3.
- According to the studies, cephalosporins, including cefazolin and ceftriaxone, are recommended for GBS prophylaxis in patients with penicillin allergy 2, 4, 3.
- The American College of Obstetricians and Gynecologists (ACOG) guidelines recommend the use of cefazolin or vancomycin for intrapartum GBS prophylaxis in patients with penicillin allergy 3.
- A study found that cefazolin was used most frequently in GBS positive patients with penicillin allergy, followed by vancomycin and clindamycin 3.
- Another study found that patients with a reported penicillin allergy were more likely to receive alternative antibiotics, including vancomycin or clindamycin, for GBS prophylaxis 4.
Antibiotic Resistance and Group B Strep
- GBS is still recognized as being universally susceptible to beta-lactam antibiotics, including cephalosporins like ceftriaxone 5.
- However, there have been reports of reduced susceptibility to beta-lactams, including penicillin, in some countries 5.
- Resistance to second-line antibiotics, such as erythromycin and clindamycin, remains high amongst GBS 2, 5.
- The use of cephalosporins, including ceftriaxone, for GBS prophylaxis may help to reduce the risk of antibiotic resistance 2, 3.
Conclusion is not allowed, the response will continue with more subheadings and bullet points if necessary
Intrapartum Antibiotic Prophylaxis
- Intrapartum antibiotic prophylaxis is effective in preventing early-onset GBS disease in newborns 6.
- The use of cephalosporins, including ceftriaxone, for GBS prophylaxis is recommended for patients with penicillin allergy 2, 4, 3.
- A study found that the effectiveness of intrapartum antibiotic prophylaxis for GBS disease was high among term and preterm deliveries 6.