Hot topics and updates

Revised CDC guidelines for preventing perinatal group B streptocccal disease

To further improve neonatal outcome, the CDC issued new GBS guidelines on August 16, 2002 which replace the CDC's 1996 guidelines. The new guidelines are intended not only for obstetrical and pediatric care providers, but also supporting microbiology laboratories, hospital administrators, and managed care organizations; childbirth educators; public health authorities; and expectant parents and their advocates.

Key changes:

• Recommendation of universal prenatal screening for vaginal and rectal GBS colonization of all pregnant women at 35–37 weeks' gestation,
  
• Updated prophylaxis regimens for women with penicillin allergy
  
• Detailed instruction on prenatal specimen collection and expanded methods of GBS culture processing, including instructions on antimicrobial susceptibility testing
  
• Recommendation against routine intrapartum antibiotic prophylaxis for GBS-colonized women undergoing planned cesarean deliveries who have not begun labor or had rupture of membranes
  
• A suggested algorithm for management of patients with threatened preterm delivery
  
• An updated algorithm for management of newborns exposed to intrapartum antibiotic prophylaxis
  from Prevention of Perinatal Group B Streptoccocal Disease - Revised Guidelines from the CDC MMWR (Morbidity and Mortality Week

Review from August 16, 2002/Volume 51/No. RR-11.
http://www.cdc.gov/mmwr/PDF/rr/rr5111.pdf

Summary of revised CDC guidelines for treatment of sexually transmitted diseases

These guidelines for the treatment of patients who have sexually transmitted diseases (STDs) were developed by the Centers for Disease Control and Prevention (CDC) after consultation with a group of professionals knowledgeable in the field of STDs who met in Atlanta on September 26–28, 2000. The information in this report updates the 1998 Guidelines for Treatment of Sexually Transmitted Diseases (MMWR 1998;47[No. RR-1]).

Included in these updated guidelines are new alternative regimens for scabies, bacterial vaginosis, early syphilis, and granuloma inguinale; an expanded section on the diagnosis of genital herpes (including type-specific serologic tests); new recommendations for treatment of recurrent genital herpes among persons infected with human immunodeficiency virus (HIV); a revised approach to the management of victims of sexual assault; expanded regimens for the treatment of urethral meatal warts; and inclusion of hepatitis C as a sexually transmitted infection. In addition, these guidelines emphasize education and counseling for persons infected with human papillomavirus, clarify the diagnostic evaluation of congenital syphilis, and present information regarding the emergence of quinolone-resistant Neisseria gonorrhoeae and implications for treatment. Recommendations also are provided for vaccine-preventable STDs, including hepatitis A and hepatitis B.

From MMWR Morbidity and Mortality Weekly Report May 10, 2002/Vol. 51/ No. RR-6 http://www.cdc.gov/std/treatment/