[Prevention of neonatal infection with group B streptococci: what the best strategy is remains unclear].

Early-onset group B streptococcal disease (GBS disease) is an important cause of morbidity and mortality in newborn infants. There is no international agreement on the best strategy for selecting pregnant women for antibiotic prophylaxis during delivery in order to reduce the incidence of this disease. A cost-effectiveness study of 4 strategies using a theoretical model showed that the risk strategy (antibiotics for women at risk) and combination strategy (antibiotics for GBS-positive women at risk) seemed more cost-effective than the current Dutch strategy (antibiotics for women at risk ifGBS positive) and the screening strategy (antibiotics for GBS-positive women). Balancing the possible effects, costs, unwanted side effects, and limitations of the implementation of either strategy in the Netherlands, the combination strategy may be a reasonable option. The possibly favourable introduction of PCR screening techniques and vaginal chlorhexidine flushing in Dutch obstetric practice deserves further scientific attention.