A pregnant woman at 36 weeks is screened and found colonized with Group B Streptococcus. She gives a clear history of anaphylaxis with angioedema and hypotension following penicillin. Which agent should be used for her intrapartum prophylaxis?

• A Cefazolin
• B Clindamycin
• C Erythromycin
• D Vancomycin ✓

Explanation

For women with GBS colonization and a history of anaphylaxis or other immediate-type hypersensitivity to penicillin, guidelines recommend vancomycin, since cross-reactivity with cephalosporins cannot be excluded and clindamycin resistance among GBS isolates is frequent enough to require susceptibility testing. Cefazolin is reserved for women at lower risk of anaphylaxis. Erythromycin is no longer recommended because of widespread GBS resistance.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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