{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T10:41:37Z","timestamp":1787568097760,"version":"build-2736575974"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Intrapartum antibiotics are often used to reduce neonatal risk of early\u2010onset Group B Streptococcus (GBS) disease. Protocols aim to achieve a fetal serum and amniotic fluid concentration above the minimum inhibitory concentration (MIC) of GBS at the time of birth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>We aimed to summarise the evidence for currently recommended doses of benzylpenicillin by comparing intrapartum fetal serum and amniotic fluid concentrations of benzylpenicillin with the associated MIC of GBS at the time of birth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We systematically reviewed PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Library, and Embase databases. We sought studies in which umbilical cord blood and\/or amniotic fluid were examined for Benzylpenicillin concentrations after intrapartum intravenous administration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seven studies were included, using a variety of doses, applying different assay techniques, and reporting a wide range of concentrations reported in the umbilical cord serum and amniotic fluid. Concentrations were often significantly higher than the target MIC of 0.125 mcg\/mL. Significant methodological limitations included reporting of total concentrations of antibiotic only and substantial protocol violations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>There is a lack of high\u2010quality evidence to support the current dosing of intrapartum antibiotics, with regards to whether appropriate MICs are achieved in the fetus. Studies applying rigorous methodology and accounting for drug protein binding are required to determine the dosing regimens required to achieve these concentrations in the umbilical cord serum and amniotic fluid.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ajo.70153","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T07:47:05Z","timestamp":1782892025000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Benzylpenicillin Concentrations in Intrapartum Group B Streptococcus Prevention Guidelines; A Systematic Review of the Evidence"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5558-8060","authenticated-orcid":false,"given":"Brian","family":"Deegan","sequence":"first","affiliation":[{"name":"Women's and Newborn Services, Royal Brisbane and Women's Hospital  Herston Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Gourlay","sequence":"additional","affiliation":[{"name":"Women's and Newborn Services, Royal Brisbane and Women's Hospital  Herston Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Eriksson","sequence":"additional","affiliation":[{"name":"UQ Library, The University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Roberts","sequence":"additional","affiliation":[{"name":"University of Queensland Centre for Clinical Research, Faculty of Medicine the University of Queensland  Brisbane Queensland Australia"},{"name":"Herston Infectious Diseases Institute (HeIDI)  Brisbane Queensland Australia"},{"name":"Department of Pharmacy and Intensive Care Medicine Royal Brisbane and Women's Hospital  Brisbane Queensland Australia"},{"name":"UR UM 103, University of Montpellier, Division of Anesthesia Critical Care and Emergency and Pain Medicine, Nimes University Hospital  Nimes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akwasi","family":"Amoako","sequence":"additional","affiliation":[{"name":"Faculty of Medicine The University of Queensland  Herston Queensland Australia"},{"name":"Department of Obstetrics and Gynaecology The Royal Brisbane and Women's Hospital  Herston Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6715-9193","authenticated-orcid":false,"given":"Victoria","family":"Eley","sequence":"additional","affiliation":[{"name":"Faculty of Medicine The University of Queensland  Herston Queensland Australia"},{"name":"Department of Anaesthesia and Perioperative Medicine Royal Brisbane and Women's Hospital  Herston Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM196412102712401"},{"key":"e_1_2_10_3_1","unstructured":"\u201cPrevention of Perinatal Group B Streptococcal Disease: A Public Health Perspective \u201d[Internet] https:\/\/www.cdc.gov\/mmwr\/preview\/mmwrhtml\/00043277.htm#00001718.htm."},{"issue":"12","key":"e_1_2_10_4_1","first-page":"e280","article-title":"Prevention of Early\u2010Onset Neonatal Group B Streptococcal Disease","volume":"124","author":"Royal College of Obstetricians and Gynaecologists","year":"2017","journal-title":"BJOG: An International Journal of Obstetrics & Gynaecology [Internet]"},{"key":"e_1_2_10_5_1","unstructured":"\u201cPrevention of Group B Streptococcal Early\u2010Onset Disease in Newborns \u201d[Internet] Acog.Org (2020) https:\/\/www.acog.org\/clinical\/clinical\u2010guidance\/committee\u2010opinion\/articles\/2020\/02\/prevention\u2010of\u2010group\u2010b\u2010streptococcal\u2010early\u2010onset\u2010disease\u2010in\u2010newborns."},{"key":"e_1_2_10_6_1","volume-title":"Queensland Clinical Guidelines Maternity and Neonatal Clinical Guideline Early Onset Group B Streptococcal Disease [Internet]","author":"Queensland Health","year":"2022"},{"key":"e_1_2_10_7_1","volume-title":"Group B Streptococcus (GBS)\u2014Prevention of Early\u2010Onset Neonatal Infection [Internet]","author":"Maternity Quality and Safety Leader\u2014Women's Health","year":"2020"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.12891"},{"key":"e_1_2_10_9_1","volume-title":"Clinical Overview of Group B Strep Disease [Internet]","author":"CDC","year":"2024"},{"key":"e_1_2_10_10_1","volume-title":"Bergey's Manual of Systematic Bacteriology. 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