Group B Streptococcal exposure management protocol
 
  Flowchart: Process: ANTIBIOTICS GIVEN? Flowchart: Process:  >4 HRS PTD? Flowchart: Decision: OBSERVE FOR >48 HRS* Text Box: MANAGEMENT OF >35 WEEK WELL BABIES WITH MOTHERS THAT HAVE INDICATION FOR INTRAPARTUM ANTIBIOTIC PROPHYLAXIS   Text Box: Text Box: Flowchart: Process: CBC/DIFF BLOOD  CULTURE Flowchart: Process:         SEPSIS               SUSPECTED    IN BABY? Flowchart: Decision:  EMPIRIC ANTIBIOTICS Flowchart: Decision:   COMPLETE WORKUP AND EMPIRIC ANTIBIOTICS Flowchart: Process: *If infant meets all discharge criteria and close follow-up with reliable at home observation is assured, may consider early DC after 24 hours in babies >38 weeks ** Maternal temperature > 100.4, with negative GBS culture - if high suspicion of chorioamnionitis (as determined by either the managing neonatologist, neonatal nurse practitioner, or pediatrician), then start a full workup and empiric antibiotics. Without a high suspicion of chorioamnionitis, workup including CBC and Blood culture should be done, and treatment should be based on laboratory or clinical assessment of the newborn. Flowchart: Process:           INDICATIONS FOR INTRAPARTUM                                               ANTIBIOTIC PROPHYLAXIS        -POSITIVE GBS CULTURE UNLESS ELECTIVE                   C/S WITHOUT LABOR OR ROM -GBS BACTERIURIA IN INDEX PREGNANCY -PRIOR BABY WITH GBS DISEASE -MATERNAL TEMP>100.4 EVEN WITH           NEGATIVE GBS CULTURE** -GBS STATUS UNKNOWN AND              -ROM>18 HOURS              -LABOR <37 WEEKS              -MATERNAL TEMP >100.4 Flowchart: Process:           IS CHORIO       SUSPECTED IN             MOTHER?** Flowchart: Decision:  CBC/DIFF BLOOD CULTURE EMPIRIC THERAPY Flowchart: Process: IS CHORIO SUSPECTED IN MOM?** Flowchart: Decision:    OBSERVE     >48 HRS
 
 
 
 
  NO
 
      YES
                           
 
      YES
 
 
     NO            NO
  NO
 
  YES         YES
 
 
  NO
          NO
 
   
 
  YES
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  CP 10/02 MW 6/03
                           
 

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