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Re: Asymptomatic bacteriuria From: Efrain Ramirez (eramirez@icepr.com) Fri Apr 21 16:23:34 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Betsy Hyde: "Re: VBAC and EFW" Previous message: Betsy Hyde: "Re: Asymptomatic bacteriuria" In reply to: Betsy Hyde: "Re: Asymptomatic bacteriuria" Next in thread: Steve & Eryl Raymond: "Re: Asymptomatic bacteriuria" At Fri, 21 Apr 2000, Betsy Hyde wrote: > >I guess I should have been more specific w/ my questions, so I will try again. > >>If you've documented ASB properly, you have a culture and sensitivity in >>hand. Use the most inexpensive, noninvasive (i.e. non-systemic, if possible) >>drug you can, from the list of susceptibles. If it happens to be ampicillin, >>so be it. > >We generally use macrodantin, for the reasons stated above. However, >sometimes ampi happens to be the cheapest abx to which the organism is >sensitive. Do any of you have concerns re overgrowth of >ampicillin-resistent ecoli w/ frequent tx of ampicillin? Would you use a >more expensive medication (ie a cephalosporin) to avoid this problem? Or >don't you perceive it as a problem? (we've had several IUFDs due to ampi >resistent ecoli sepsis, so that is what drives my questions.) "Several" IUFD's due to ampi resistent ecoli sepsis? that's rare--at least where I work -- One always have a concern of overgrowth -- I use ampicillin-augmentin-macrodantin. No I do not keep treating low levels of GBS in the urine. I treat once GBS during pregnancy, more if symptomatic -then in labor. >> >>If there is + GBS in the urine, then that implies a rather heavy colonization >>in vagina and rectum. Those people are declared "high risk" GBS-wise by most >>folks and treated accordingly. > >right....treated in labor. But, given that it is impossible to eradicate >the gi source of GBS, we see GBS UTIs that never go away.....10K, >25K...always there. Do you keep treating low levels of GBS in the urine >*prior* to labor? > >Hope this is more clear. > >-- >Betsy Hyde CNM >Branford, CT > -- "The things you learn after you know everything are the important ones" Next message: Betsy Hyde: "Re: VBAC and EFW" Previous message: Betsy Hyde: "Re: Asymptomatic bacteriuria" In reply to: Betsy Hyde: "Re: Asymptomatic bacteriuria" Next in thread: Steve & Eryl Raymond: "Re: Asymptomatic bacteriuria"

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