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Re: UA resultsFrom: ainsron (ainsron@sbcglobal.net)Thu Jun 8 10:26:14 2006
Since you are outside of the first trimester, Cipro would be my drug of choice, based on the sensitivities. The overall risk is low with no pattern of anomalies in studies, although drug induced fetal cartilage damage and arthropathies are a concern in animal studies. TCN would not be a good choice, Ceftriaxone would require parenteral administration, as would Gentamycin, so I would use either if she had to be hospitalized. Levaquin is also a quinolone, like Cipro, but according to Briggs, there are no studies on its use and studies on ofloxacin, its optical isomer, has not excluded a causal relationship with birth defects. Ronald E. Ainsworth, MD, FACOG -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Elrod, Darryl G Maj 48 MDOS/SGOBO Sent: Thursday, June 08, 2006 1:55 AM To: Multiple recipients of list OB-GYN-L Subject: UA results This urine culture showed up on a 24 wk G3P1102 with a history of pyelonephritis and who was already on prophylactic macrodantin. At the time this was taken, she was seen in L&D for contractions. Her cervical length was 3.8 cm with a closed internal os. Based on the multiple drug resistances, what would you place her on for treatment? Organism: (1) ESCHERICHIA COLI. . . . . . . . .quantity: >100,000 CFU/ML (1) Mcg/ml Interp CEFAZOLIN >2 R + CEFTRIAXONE <=8 S CEFUROXIME-SODIU >2 R CIPROFLOXACIN <=0.5 S GENTAMICIN 1 S TETRACYCLINE <=1 S TRIMETH/SULFA >20 R NITROFURANTOIN 64 I AMOXICILLIN/CA 16 I AMPICILLIN-GRAM >2 R LEVOFLOXACIN <=1 S Thanks, Glen //SIGNED// D. Glen Elrod, Maj., USAF, MC Obstetrician/Gynecologist Chief of Obstetrics 48 MDOS/SGOBO RAF Lakenheath, England Telephone DSN: 314-226-8130 Comm: +44 (0) 1638 52 8130 Notice of Confidentiality Under the Privacy Act of 1974, you must safeguard all information reflected on this e-mail and, if applicable, all attachments. Disclosure of information is IAW AFI 33-119, AFI 33-127, AFI 37-131, AFI 37-132, AFI 33-219, and PL 93-579" This e-mail message including any attachments is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. Any questions pertaining to disclosure should be directed to the privacy officer.
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