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To the Editor: The study of the epidemiology of invasive group B streptococcal disease in the United States by Dr Phares and colleagues¹ found that intervention was associated with a reduction in incidence of 1.3 in every 10 000 live births. This absolute reduction seems small to me in spite of the 27% relative risk reduction. To accept these numbers as justification to continue current practice does not consider the cost of testing and therapy, the effects of antibiotic therapy on resistance patterns, or the differential treatment of otherwise well newborns. Starting all infants exposed to group B streptococcus with intravenous antibiotic therapy would certainly result in morbidity. It is not clear that group B streptococcal screening and treatment of all culture-positive mothers would result in a net benefit.

Financial Disclosures: None reported.

Clyde Mitchell, MD
cmitchell@stj.net
School of Medicine
West Virginia University
Buckhannon

1. Phares C, Lynfield R, Farley M; et al. Epidemiology of invasive group B streptococcal disease in the United States, 1999-2005. JAMA. 2008;299(17):2056-2065. FREE FULL TEXT

Letters Section Editor: Robert M.Golub, MD, Senior Editor.

JAMA. 2008;300(14):1649.

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RELATED ARTICLE

Epidemiology of Invasive Group B Streptococcal Disease in the United States, 1999-2005
Christina R. Phares, Ruth Lynfield, Monica M. Farley, Janet Mohle-Boetani, Lee H. Harrison, Susan Petit, Allen S. Craig, William Schaffner, Shelley M. Zansky, Ken Gershman, Karen R. Stefonek, Bernadette A. Albanese, Elizabeth R. Zell, Anne Schuchat, and Stephanie J. Schrag
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Reductions in Incidence of Invasive Group B Streptococcal Disease in the United States—Reply
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