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Re: Group B Beta strept screening From: Efrain Ramirez (eramirez@icepr.com) Fri Jan 28 13:13:43 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Luis Sanchez-Ramos: "Re: Group B Beta strept screening" Previous message: Efrain Ramirez: "Re: Group B Beta strept screening" In reply to: ainsron@msn.com: "Re: Group B Beta strept screening" Next in thread: Garry Siegel: "Re: Group B Beta strept screening" Reply: Garry Siegel: "Re: Group B Beta strept screening" How many of the listmembers have had anaphylactic reactions to antibiotics in labor? How many of the list members have had babies with severe neonatal sepsis/deaths because of GBS? Me? never a reaction in almost 30 years. Babies?-- do not have an exact number but at least 4-5 deaths and more than a dozen very sick ones. I know I am biased and have no data--maybe in Puerto Rico the colonization rate is higher than in other places--I don't know--maybe I'll change my mind--who knows-- but it better be a good data to show me that I am harming patients. At least must be better than " 1) the natural history of colonization shows that although 25% of people are colonized at any given time, it's *not* the same 25% - colonization comes and goes; " yeah--sure--umjú. At Thu, 27 Jan 2000, Cheri Van Hoover wrote: > >Jim Connerth wrote: > >> No need to screen-assume colonization and Rx in labor--- >> >> Lily Kay CNM wrote: >> >> > If a woman has had a positive GBBS culture in a previous >> > pregnancy, should she be rescreened in subsequent pregnancies, or >> > assumed to be colonized and given prophylaxis in labor without >> > rescreening? > >This is not the CDC recommendation. > >I asked this question of Stanford's Bill Benitz at a recent conference. >He's done a very impressive job of reviewing the risk factors for GBS >and putting together an odds ratio analysis. I'm including the >reference to his recent article in Pediatrics below. He said that women >should not be treated in labor based on a previous colonization (as >opposed to previous infant with GBS disease). The reasons: 1) the >natural history of colonization shows that although 25% of people are >colonized at any given time, it's *not* the same 25% - colonization >comes and goes; 2) there is concern in the pediatric community about the >increase in antibiotic-resistant enterococcal sepsis of the newborn >which they believe is a product of the rise in GBS prophylaxis; and 3) >the risk of maternal allergic reaction (including anaphylaxis) is not >insignificant - and the fetus can be damaged by adverse maternal >response to antibiotics without full maternal anaphylaxis. > >Benitz WE, Gould JB, Druzin ML. Risk factors for early-onset group B >streptococcal sepsis: Estimation of odds ratios by critical literature >review. Pediatrics 1999; 103:e77. URL: >http://www.pediatrics.org/cgi/content/full/103/6/e77 > >-- >Cheri Van Hoover, CNM >San Francisco, CA > -- "The things you learn after you know everything are the important ones" Next message: Luis Sanchez-Ramos: "Re: Group B Beta strept screening" Previous message: Efrain Ramirez: "Re: Group B Beta strept screening" In reply to: ainsron@msn.com: "Re: Group B Beta strept screening" Next in thread: Garry Siegel: "Re: Group B Beta strept screening" Reply: Garry Siegel: "Re: Group B Beta strept screening"

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