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Re: GBS and HRT--Breast caFrom: Harnath Holmes (holmes@fallsnet.com)Sat Jan 29 16:59:49 2000
Right now I can't even get PCN. The hospital has 3 vials left and their supplier won't ship any until the fall. Initially I liked the "risk factor based" way of antibiotic prophylaxsis. Fewr women were treated but the scenarios of a past GBS + culture or unk GBS culture were eliminated. I have had babies die of GBS so I know its real. However most of the MFM groups went right to screening cultures and abandoned the risk factor approach, therefore I changed to the screening. I have been seeing a lot more patients turn up positive and therefore am treating a lot more women in labor. But I am not sure we can take a 'step back' to risk factor triage. On the HRT note, Most of their discussion seemed to defend possible bias. Many of their confidence intervals contained 1.0 which I thought ment they weren't very confident. In all those women studied they could only find 33 for one conclusion? Hard to base changing everyone's HRT on 33 women. Yes I get lots of questions about these "news media" studies. It is very hard to convince someone of the other benefits after Oprah or Dan Rather has told them that the HRT will give you breast cancer. Does anyone think the new micronized progesterone will be different or how about the new norgestimate (ortho prefest) or the other new one (Femhrt) will be different? Is it really just provera or all progestins? Har Holmes, MD FACOG Little Falls, MN PS. No central monitors here either Jane.
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