Treatment of Group B Strep
The treatment of Group B Strep focuses on eradicating the infection with antibiotics and preventing transmission in high-risk populations. In pregnant women, the treatment of Group B Strep is primarily aimed at reducing the risk of neonatal infection. In newborns and vulnerable adults, immediate antibiotic therapy is vital to avoid life-threatening complications such as sepsis and meningitis.
Group B Streptococcus (GBS) is a bacterium commonly carried without symptoms, but when it causes infection, prompt medical intervention becomes essential. Treatment protocols vary depending on whether the individual is colonised, symptomatic, or suffering from an invasive disease.
Treatment During Pregnancy and Labour
1. Intrapartum Antibiotic Prophylaxis (IAP)
Pregnant women who test positive for GBS colonisation are not treated during pregnancy, but they are given intravenous antibiotics during labour to prevent transmission to the baby.
Penicillin G is the drug of choice
Ampicillin is an acceptable alternative
Cefazolin, clindamycin, or vancomycin may be used for those allergic to penicillin
The antibiotic should be administered at least four hours before delivery to ensure it has sufficient time to reduce bacterial levels in the birth canal.
Intrapartum antibiotics are recommended if:
The woman tested positive for GBS at 35–37 weeks
She previously had a baby with GBS disease
GBS was found in her urine during the current pregnancy
She presents in labour before screening results are available and has risk factors (fever, prolonged rupture of membranes)
Prophylaxis is not needed in cases of planned caesarean delivery before labour begins and before membranes rupture.
2. Treating GBS-Related Infections in Pregnancy
Doctors give oral or intravenous antibiotics during pregnancy if Group B Streptococcus (GBS) causes urinary tract infections or chorioamnionitis. These infections may increase the risk of preterm birth and require close monitoring.
Treatment in Newborns
Babies suspected of having GBS disease—whether early- or late-onset—require immediate hospital admission and intravenous antibiotics. Doctors typically begin treatment before confirming test results because the infection can progress rapidly
First-Line Treatment:
Benzylpenicillin (or ampicillin)
Gentamicin (an aminoglycoside for broad coverage)
Treatment duration depends on the severity and type of infection:
Sepsis: 7–10 days
Pneumonia: 7–10 days
Meningitis: 14–21 days
Monitoring and Supportive Care
In addition to antibiotics, supportive care may include:
Oxygen or ventilation for breathing difficulties
Intravenous fluids for hydration and stabilising blood pressure
Monitoring of heart rate, breathing, and temperature
Nutritional support if feeding is poor
In neonatal intensive care units (NICUs), continuous observation ensures early detection of treatment response or deterioration.
Treatment in Non-Pregnant Adults
While most adults carry GBS without symptoms, immunocompromised individuals, the elderly, and those with underlying health issues may develop serious infections.
Treatment of GBS Infections in Adults:
Penicillin G or amoxicillin is usually first-line
Doctors typically require hospitalisation to administer intravenous antibiotics and monitor the patient.
For penicillin-allergic patients, vancomycin is an effective alternative
Treatment length varies depending on the infection site:
Urinary tract infections: 5–7 days
Skin and soft tissue infections: 10–14 days
Sepsis: 10–14 days
Osteomyelitis or joint infections: 4–6 weeks
Meningitis: 14–21 days
Doctors typically require hospitalisation to administer intravenous antibiotics and monitor the patient.
Antibiotic Resistance and Challenges
Group B Strep remains largely susceptible to beta-lactam antibiotics, including penicillin. However:
Doctors recommend resistance testing if the patient cannot use penicillin.
Doctors recommend resistance testing if the patient cannot use penicillin
Misuse or overuse of antibiotics may contribute to resistance over time
Maintaining prudent antibiotic practices is essential to preserve treatment effectiveness.
Emerging Therapies and Vaccine Development
Currently, no licensed vaccine exists for GBS. However, research is underway to develop maternal vaccines that:
Stimulate antibody production during pregnancy
Pass protection to the baby through the placenta
Reduce reliance on intrapartum antibiotics
Such vaccines may prove especially valuable in low-resource settings without access to routine screening.
Conclusion | Treatment of Group B Strep
The treatment of Group B Strep varies based on the patient’s risk and presentation. In pregnant women, intrapartum antibiotics significantly reduce neonatal infection risk. Doctors rely on intravenous antibiotics and supportive care to treat newborns and adults with invasive disease.
