To the Editor.

We are indebted to Drs Gotoff and Boyer¹ for their insights regarding prevention of early-onset neonatal group B streptococcal (GBS EOD) infection. In their commentary, they make three points that merit emphasis and comment. First, the strategy recently recommended by the Centers for Disease Control and Prevention (CDC)² may not be the most efficient or cost-effective way of dealing with this problem, and "there is no current agreement on the approach to chemoprophylaxis of GBS EOD." It should be clear that the CDC recommendations, even with endorsements by the American College of Obstetricians and Gynecologists (ACOG)³ and the American Academy of Pediatrics (AAP)⁴ do not establish a national standard of care for management of this problem. Second, there is a danger that failure to explicitly include chorioamnionitis as an indication for treatment in the CDC's "screening-based approach" could result in failure to treat women with chorioamnionitis, because the recommendations indicate that "no intrapartum prophylaxis [is] needed" for febrile women with . . . [Full Text of this Article]