1. Offer all women screening for group B streptococcal disease at 35 to 37 weeks’ gestation with culture
done from one swab first to the vagina then to the rectal area. (II-1)
2. Treat the following women intrapartum at time of labour or rupture of membranes with IV antibiotics:
• all women positive by GBS culture screening done at 35 to 37 weeks (II-2)
• any women with
an infant previously infected with GBS (II-3)
• any women with documented GBS bacteriuria (regardless of level of
colony-forming units per mL) in this pregnancy (II-2)
3. Treat women at less than 37 weeks’ gestation with IV antibiotics unless there has been a negative GBS
vaginal/rectal swab culture within 5 weeks. (II-3)
4. Treat women with intrapartum fever with IV antibiotics (i.e., chorioamnionitis must be treated, but broader
spectrum antibiotics would be advised). (II-2)
5. If a woman is GBS-positive by culture screening or by history of bacteriuria, with prelabour rupture of membranes
at term, treat with GBS antibiotic prophylaxis and initiate induction of labour with IV oxytocin (II-1)
6. If GBS culture result is unknown and the woman has ruptured membranes at term for greater than 18 hours,
treat with GBS antibiotic prophylaxis. (II-2)
