Group B streptococcus in the Northern Territory in 2023: clindamycin down but not out.

Group B streptococcus (GBS) is a significant cause of perinatal morbidity and mortality; prophylactic antibiotics in the obstetric population can mitigate the risk of neonatal infection. The antibiotic of choice is penicillin; however, in women who have a penicillin hypersensitivity, clindamycin is the preferred agent. Worldwide resistance to clindamycin is rising in GBS isolates. In the Top End of the Northern Territory of Australia, we reviewed 113 GBS isolates in 2023. These GBS isolates revealed a 30% resistance to clindamycin. This rate has considerably increased since the Australia-wide survey published in 2011 where GBS resistance to clindamycin was quoted at 4.2%. As a result of this study, we are advocating for a change in practice in patients with known GBS resistance with penicillin hypersensitivity.