The epidemiology and pathogenesis of early-onset group B streptococcal disease (GBS EOD) have been well-studied. Group B streptococci (GBS) colonize the gastrointestinal tract and vagina in 15% to 40% of women (median = 20%) and are transmitted to the newborn before or during delivery through a vertical or ascending route. Because the majority of newborns are symptomatic within the first hour of life, most infections appear to have their onset in utero, usually during labor. GBS are sensitive to the penicillins, and prenatal, intrapartum, and postpartum chemoprophylaxis with penicillin or ampicillin has been investigated in uncontrolled and controlled studies (reviewed in references 2 and 3).

Prenatal administration of ampicillin or penicillin to colonized pregnant women does not eradicate colonization or prevent transmission to the newborn unless it is given immediately before labor. Because of lack of efficacy, this approach has been discouraged. Nevertheless, some obstetricians...

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