Treatment Overview

Group B Streptococcus (GBS) is a common bacterium that naturally resides in the body of many healthy adults, typically in the digestive tract or genital areas. For most people, “carrying” GBS is not a disease and causes no symptoms. However, it can become a significant health concern during pregnancy or for individuals with weakened immune systems. The knowledge that you carry this bacteria can cause anxiety, particularly for expecting parents worried about transmitting it to their newborn, or for adults experiencing invasive infections like urinary tract infections or pneumonia.

Treatment is critical in two distinct scenarios: preventing transmission from mother to baby during labor and curing active infections in adults or infants. The goal is to eliminate the bacteria from the bloodstream or affected tissue to prevent serious complications such as sepsis or meningitis. Because medical history, specifically drug allergies plays a major role in safety, doctors tailor medication plans to the individual. Treatment protocols differ significantly depending on whether the goal is preventative prophylaxis or acute management of an active illness (Centers for Disease Control and Prevention, 2022).

Overview of treatment options for Streptococcal Group B Infection

The management of Group B Strep is almost exclusively reliant on antibiotic therapy. There are no home remedies or lifestyle changes that can eliminate the bacteria.

For pregnant women who test positive for GBS, treatment is preventative. It involves administering antibiotics intravenously (IV) during labor. This is not intended to “cure” the mother of the carrier state but to clear the bacteria temporarily from the birth canal to protect the baby during delivery.

For adults with active GBS infections (such as skin infections, bone infections, or UTIs) and for newborns who develop GBS disease, the approach is curative. This involves a course of antibiotics to kill the bacteria causing the illness. The duration and method of delivery (IV vs. oral) depend on the severity of the infection.

Medications used for Streptococcal Group B Infection

Penicillin remains the gold standard for treating Group B Strep. It is the most effective and widely studied antibiotic for this specific bacterium. In a labor and delivery setting, Penicillin G is the first-line choice. Ampicillin, a similar drug in the penicillin family, is a common alternative. Clinical experience suggests that administering these antibiotics at least four hours before delivery significantly reduces the risk of the baby developing an infection.

For patients who are allergic to penicillin, doctors must select alternatives based on the severity of the allergy and the resistance patterns of the bacteria.

  • Cefazolin: Often used for women with mild penicillin allergies (those who do not have a risk of anaphylaxis).
  • Clindamycin: A potential option for those with severe penicillin allergies, though testing is required to ensure the specific GBS strain is susceptible to it.
  • Vancomycin: Reserved for patients with severe allergies to penicillin whose GBS strain is resistant to clindamycin.

For active infections in adults, oral antibiotics like penicillin or cephalexin may be prescribed for milder cases, while severe invasive infections require hospital-based IV therapy (American College of Obstetricians and Gynecologists, 2020).

How these medications work

Beta-lactams (penicillin, ampicillin, cefazolin) kill bacteria by inhibiting the enzymes that build the cell wall, causing the bacteria to burst.

Clindamycin inhibits protein synthesis by targeting bacterial ribosomes, halting growth and reproduction. Vancomycin also attacks the cell wall, but via a different mechanism than penicillin, allowing its use when penicillin fails (National Institutes of Health, 2023).

Side effects and safety considerations

Antibiotics are generally safe but have side effects. Common issues include gastrointestinal distress (nausea, diarrhea, stomach pain) and mild injection site reactions for women treated during labor.

The most serious risk is an allergic reaction, ranging from a mild rash to life-threatening anaphylaxis. Patients must report past antibiotic allergies. Use can also cause secondary yeast infections or, rarely, severe C. difficile diarrhea. Immediate medical care is needed for hives, difficulty breathing, or severe, watery diarrhea.

Since everyone’s experience with the condition and its treatments can vary, working closely with a qualified healthcare provider helps ensure safe and effective care.

References

  1. Centers for Disease Control and Prevention. https://www.cdc.gov
  2. American College of Obstetricians and Gynecologists. https://www.acog.org
  3. National Institutes of Health. https://www.nih.gov
  4. Mayo Clinic. https://www.mayoclinic.org

Medications for Streptococcal Group B Infection

These are drugs that have been approved by the US Food and Drug Administration (FDA), meaning they have been determined to be safe and effective for use in Streptococcal Group B Infection.

Found 2 Approved Drugs for Streptococcal Group B Infection

Azithromycin

Brand Names
Azasite, Zithromax

Azithromycin

Brand Names
Azasite, Zithromax
Form: Injection, Tablet, Powder, Suspension, Solution
Method of administration: Oral, Intravenous, Parenteral, Ophthalmic
FDA approval date: October 19, 1995
Classification: Macrolide Antimicrobial
Azithromycin for oral suspension USP is a macrolide antibacterial drug indicated for the treatment of patients with mild to moderate infections caused by susceptible strains of the designated microorganisms in the specific conditions listed below. Recommended dosages and durations of therapy in adult and pediatric patient populations vary in these indications.

Cefoxitin

Generic Name
Cefoxitin

Cefoxitin

Generic Name
Cefoxitin
Form: Injection, Powder
Method of administration: Intravenous
FDA approval date: March 10, 2006
Classification: Cephalosporin Antibacterial
Treatment: CEFOXITIN FOR INJECTION, USP is indicated for the treatment of serious infections caused by susceptible strains of the designated microorganisms in the diseases listed below. Lower respiratory tract infections, including pneumonia and lung abscess, caused by Streptococcus pneumoniae, other streptococci (excluding enterococci, e.g., Enterococcus faecalis [formerly Streptococcus faecalis ]), Staphylococcus aureus (including penicillinase-producing strains), Escherichia coli, Klebsiella species, Haemophilus influenzae, and Bacteroides species. Urinary tract infections caused by Escherichia coli, Klebsiella species, Proteus mirabilis, Morganella morganii, Proteus vulgaris and Providencia species (including P. rettgeri ). Intra-abdominal infections, including peritonitis and intra-abdominal abscess, caused by Escherichia coli, Klebsiella species, Bacteroides species including Bacteroides fragilis, and Clostridium species. Gynecological infections, including endometritis, pelvic cellulitis, and pelvic inflammatory disease caused by Escherichia coli, Neisseria gonorrhoeae (including penicillinase-producing strains), Bacteroides species including B. fragilis, Clostridium species, Peptococcus niger, Peptostreptococcus species, and Streptococcus agalactiae. CEFOXITIN FOR INJECTION, USP, like cephalosporins, has no activity against Chlamydia trachomatis. Therefore, when CEFOXITIN FOR INJECTION, USP is used in the treatment of patients with pelvic inflammatory disease and C. trachomatis is one of the suspected pathogens, appropriate anti-chlamydial coverage should be added. Septicemia caused by Streptococcus pneumoniae, Staphylococcus aureus (including penicillinase-producing strains), Escherichia coli, Klebsiella species, and Bacteroides species including B. fragilis. Bone and joint infections caused by Staphylococcus aureus (including penicillinase-producing strains). Skin and skin structure infections caused by Staphylococcus aureus (including penicillinase-producing strains), Staphylococcus epidermidis, Streptococcus pyogenes and other streptococci (excluding enterococci e.g., Enterococcus faecalis [formerly Streptococcus faecalis ]), Escherichia coli, Proteus mirabilis, Klebsiella species, Bacteroides species including B. fragilis, Clostridium species, Peptococcus niger, and Peptostreptococcus species. Appropriate culture and susceptibility studies should be performed to determine the susceptibility of the causative organisms to CEFOXITIN FOR INJECTION, USP. Therapy may be started while awaiting the results of these studies. In randomized comparative studies, CEFOXITIN FOR INJECTION, USP and cephalothin were comparably safe and effective in the management of infections caused by gram-positive cocci and gram-negative rods susceptible to the cephalosporins. CEFOXITIN FOR INJECTION, USP has a high degree of stability in the presence of bacterial beta-lactamases, both penicillinases and cephalosporinases. Many infections caused by aerobic and anaerobic gram-negative bacteria resistant to some cephalosporins respond to CEFOXITIN FOR INJECTION, USP. Similarly, many infections caused by aerobic and anaerobic bacteria resistant to some penicillin antibiotics (ampicillin, carbenicillin, penicillin G) respond to treatment with CEFOXITIN FOR INJECTION, USP. Many infections caused by mixtures of susceptible aerobic and anaerobic bacteria respond to treatment with CEFOXITIN FOR INJECTION, USP. Prevention: CEFOXITIN FOR INJECTION, USP is indicated for the prophylaxis of infection in patients undergoing uncontaminated gastrointestinal surgery, vaginal hysterectomy, abdominal hysterectomy, or cesarean section. If there are signs of infection, specimens for culture should be obtained for identification of the causative organism so that appropriate treatment may be instituted. To reduce the development of drug-resistant bacteria and maintain the effectiveness of CEFOXITIN FOR INJECTION, USP and other antibacterial drugs, CEFOXITIN FOR INJECTION, USP should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.
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