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Re: Asymptomatic bacteriuria From: Steve & Eryl Raymond (eryl@intekom.co.za) Sat Apr 22 16:07:25 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Steve & Eryl Raymond: "Re: focal skin necrosis after Cohen incision" Previous message: Steve & Eryl Raymond: "Re: Early repair complete dehiscence of 4th degree tear -" In reply to: Betsy Hyde: "Re: Asymptomatic bacteriuria" Next in thread: Rupak Roy: "Re: Asymptomatic bacteriuria" For what it's worth here's what we do: Asymptomatic bacteriuria is always treated. Starting with Furadantin (Nitrofurantoin) 50mg tds for 5 days. If this eradicates the infection, retesting at 37/40. If eradication is not achieved they stay on Furadantin 50mg bd for the rest of the pregnancy. As CDC recommends all women have a HVS at 37/40 we try to do that looking for GBS, and treat in labour, if present, with Ampicillin and Gentamycin. Another posting asked about amnionitis and concerns about treating during labour in case it had a "resistance" effect on the baby. It seems most paediatricians do not believe it produces problems to treat in labour, and in fact it limits the risks to the baby to do so. Steve Raymond On 21 Apr 2000, at 16:11, Betsy Hyde wrote: > >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.) > > > > >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? YES Next message: Steve & Eryl Raymond: "Re: focal skin necrosis after Cohen incision" Previous message: Steve & Eryl Raymond: "Re: Early repair complete dehiscence of 4th degree tear -" In reply to: Betsy Hyde: "Re: Asymptomatic bacteriuria" Next in thread: Rupak Roy: "Re: Asymptomatic bacteriuria"

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