Emerging treatments
Antibiotics for use in adults
Two intravenous glycopeptide antibiotics, dalbavancin and oritavancin, have been approved for treating acute bacterial skin and skin-structure infections (ABSSSI), including infections caused by susceptible group B streptococcus. These agents have the potential advantage of being administered as a one-off single dose. Tedizolid, an oxazolidinone antibiotic, has also been approved for the treatment of ABSSSI, including infections caused by susceptible group B streptococcus. Delafloxacin is a new fluoroquinolone that has been approved for the treatment of ABSSSI caused by designated susceptible bacteria. Omadacycline is a new tetracycline antibiotic that has been approved for the treatment of community-acquired bacterial pneumonia and ABSSSI caused by designated susceptible bacteria. The precise role of dalbavancin, oritavancin, tedizolid, delafloxacin, and omadacycline in the management of confirmed GBS disease is yet to be determined.
Vaccines
Maternal GBS vaccines are in early-stage clinical development. GBS6, a hexavalent conjugate vaccine, induced an adequate immune response and was well tolerated in healthy nonpregnant adults in one phase 1/2 randomized, placebo-controlled clinical trial.[96] One phase 2 trial is under way to assess its efficacy and safety in healthy nonpregnant and pregnant women.[97] Other candidates in phase 2 clinical trials include GBS-NN/NN2, a protein subunit vaccine that is being evaluated in pregnant women with and without HIV.[98]
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