Control of perinatal group B streptococcal sepsis: Efficacy of single injection of aqueous penicillin at birth

Early onset Group B (GBS) streptococcal disease results from systemic invasion by GBS following superficial contamination fro the mother's birth canal. Its clinical couse is often fulminating beginning shortly after birth and cuasing several thousand deaths annually in the USA. Therapy begun after diagnosis is often unavailing, with a mortality rate of 50%. Control of the disease therefore depends upon prompt preventive measures. Attempts to eradicate the maternal carrier state of GBS by using antibiotics gives erratic results and is ineffective. Active immunization of mothers with vaccines has been suggested as a possible approach; this is an area for continued study which offers no applicable preventive modality at present. At The Mount Sinai Medical Center's hospitals, a single intramuscular injection of 50,000 units of aqueous penicillin given at birth in the delivery room to all live-born babies avoids early onset invasive GBS disease. External contamination is not affected. Systemic protection is due to the plasma penicillin levels; all strains of GBS have a low minimal inhibitory concentration (MIC). More than 130,000 deliveries have been so managed since 1952. Prospective controlled trials of this method conducted in a number of geographically separated obstetrical centers are urgently recommended.