A laboring client who is positive for group B Streptococcus (GBS) is given an initial dose of 2 g of ampicillin at 9 AM. According to established guidelines for intrapartum management of this client, what should the next dose be?

The next dose will be 1 g of ampicillin after 4 hours.

Intrapartum antibiotic administration to women with group B that tested ampicillin or penicillin G, either antibiotic should first be considered for(2 g of ampicillin IV followed by 1 g every four hours until giving birth.

Explanation:

Group B streptococci (GBS) colonizes the vagina and rectum in 10–30% of pregnant women.1 In the newborn, GBS is a leading cause of neonatal sepsis and a major cause of pneumonia and meningitis.2

In 2002, the Centers for Disease Control and Prevention (CDC) issued guidelines to recommend that all pregnant women be screened at 35–37 weeks of gestation for GBS and, if positive, treated with intrapartum antibiotic prophylaxis. The aims of prophylaxis are 1) to decrease colony counts at the time of delivery; 2) to prevent the organism from ascending and proliferating in the amniotic fluid compartment; and 3) to achieve adequate levels of effective antibiotic in the fetal bloodstream during labor.

For Ampicillin  nonallergic patients, the protocol recommends a 2 g unit infusion of ampicillin, followed by 1 g  every 4 hours until delivery.3 At least 4 hours of intrapartum antibiotic prophylaxis are recommended.

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