Randomized Clinical Trial of Intrapartum Clindamycin Cream for Reduction of Group B Streptococcal Maternal and Neonatal Colonization

Objective: In a randomized trial, we sought to determine whether 2% clindamycin cream administered intravaginally during labor to group B streptococcal-colonized pregnant women without risk factors would decrease maternal and neonatal colonization. Methods: The eligible women were randomized to receive either cream or no treatment. Two hours after treatment or admission, the patients were tested with rectal and vaginal cultures. The neonates of the study patients were also tested. Results: Of women randomized to cream, 5 of 5 remained positive and 2 (33%) of their 6 neonates were positive. Of 4 randomized to no treatment, 3 (75%) remained positive and 1 (25%) of 4 neonates was positive. Conclusions: Intravaginal 2% clindamycin cream was ineffective in reducing colonization with group B streptococci.