BACKGROUND:
Group B Streptococcus (GBS) is a leading cause of neonatal infections. In Norway, women with pre-labour rupture of membranes (PROM) or preterm PROM (PPROM) are routinely treated with antibiotics due to delayed laboratory diagnostics. This practice results in widespread, often unnecessary antibiotic exposure to both mothers and neonates. Reducing such exposure is a key goal of Norway’s Action Plan to Combat Antimicrobial Resistance.

OBJECTIVES:
To evaluate the effect of implementing point-of-care (POC) PCR testing for GBS in women with PROM and PPROM, with the aim of reducing unnecessary antibiotic use while maintaining patient safety.

METHODS:
A multidisciplinary team at the University Hospital of North Norway (UNN) Tromsø introduced rapid POC PCR testing for GBS in pregnant women with PROM after 18 hours at term and immediately in cases of PPROM (35–37 weeks). Midwives performed bedside testing and treatment decisions were based on the result. Data were collected over a 12-month period and compared to previous standard care.

RESULTS:
Of 129 women tested, only 35 (27%) were GBS-positive. As a result, 94 women and their infants avoided unnecessary antibiotic exposure. This led to a 39.8% reduction in antibiotic use at the maternity unit. Additional benefits included reduced inpatient stays (23.5 days saved) and elimination of 129 unnecessary lab analyses. No cases of neonatal GBS disease occurred during the study period.

CONCLUSIONS:
Introducing POC GBS testing in women with PROM and PPROM reduced antibiotic use by nearly 40% without compromising safety. The project aligns with national goals for antimicrobial resistance reduction and demonstrates the value of patient-near diagnostics in obstetric care. The approach is scalable and transferable to other maternity wards.

KEY MESSAGE:
Implementing point-of-care PCR testing for GBS in women with PROM and PPROM led to a 40% reduction in antibiotic use, aligning with national AMR goals and improving targeted care without compromising neonatal safety. Poster session 4 (Group B)