Prévention de l'infection néonatale à streptocoque du groupe B : Stratégies des médecins à Winnipeg, au Manitoba

OBJECTIVE To determine how family physicians in Winnipeg, Man, approach prevention of neonatal group B streptococcal (GBS) infection, what influences their decisions, and whether their decisions differ from those of local obstetricians. DESIGN Population-based survey. SETTING Family physicians’ and obstetricians’ practices in Winnipeg. PARTICIPANTS Eighty-five physicians and residents with hospital labour floor privileges. MAIN OUTCOME MEASURES Individual approaches to prevention of neonatal GBS infection, factors influencing choice of approach, and perceptions of neonatal GBS disease and universal prenatal GBS screening. RESULTS About 66% of family physicians and their residents followed the Society of Obstetricians and Gynaecologists of Canada’s (SOGC) guidelines for universal GBS screening and intrapartum antibiotic prophylaxis of all GBS carriers. This was significantly fewer than the 87% of obstetricians who followed these guidelines (P = .026). Obstetricians were more likely than family physicians to cite the literature as influencing their approach to neonatal GBS prevention (P < .001). Family physicians were more likely to cite the influence of peers and colleagues (P = .04). The incidence of neonatal GBS and its associated mortality were overestimated by 61% and 55% of obstetricians, and 66% and 57% of family physicians, respectively. Despite concerns about the risks and costs of universal GBS screening and intrapartum antibiotic prophylaxis, 92% of obstetricians and 79% of family physicians thought that the benefits of universal screening outweighed the concerns. About 24% of obstetricians and 30% of family physicians were theoretically willing to expose more than 10 000 women to intrapartum prophylactic antibiotics to prevent a single neonatal GBS-related death. CONCLUSION Family physicians were less likely than obstetricians to follow current SOGC guidelines for prevention of neonatal GBS disease. This could reflect a different perspective on patient care. Family physicians want patients to be involved in screening decisions based on full disclosure of potential harm and benefit. This article has been peer reviewed. Full text available in English at www.cfpc.ca/cfp. Can Fam Physician 2007;53:289-290 EDITOR’S kEy POINTS • There are currently 3 main approaches to prevention of neonatal group B streptococcal (GBS) infection that are espoused by various groups. There are no guidelines for prevention of GBS infection designed specifically for family physicians. • The authors of this study recommend that guidelines for family physicians be developed and that these guidelines incorporate patient involvement in decision making. • Given that both family physicians and obstetricians overestimate the prevalence of GBS neonatal infection and the mortality associated with it, there is an opportunity for education in this area.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.