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Re: Strep prophylaxisFrom: Braun, R. Daniel (rbraun@iupui.edu)Thu Feb 13 04:39:16 2003
AMEN!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! Dan -----Original Message----- From: DoctorJoe@aol.com [mailto:DoctorJoe@aol.com] Sent: Wednesday, February 12, 2003 5:43 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Strep prophylaxis In a message dated 2/12/03 15:55:14, apgar10@montanadsl.net writes: Hey Listers, I have had several "lay" midwives inquire about strep prophylaxis. Apparently they are using a protocol of Rocephin via intramuscular injection near the onset of labor. Is anybody aware of any validated protocols using this method - I am not. I know there are some programs doing a bicillin injection protocol, but I don't think they are concluded as yet... Lynn Theoretically, it should work. As you say, no validation yet. I can see the alure of it - one injection that lasts a LONG time. However... remember what happened when ampicillin was used almost universally - ampicillin-resistant gram negatives up the whazoo! So people gravitated to plain penicillin, to keep the resistance a little bit more reasonable. NOW what are we going to do? One of our best gram negative drugs, ceftriaxone, is going to be used prophyllactically? So we get lots of ceftriaxone resistance in the community, like in the gonococcus and other organisms? I would STRONGLY advise against using ceftriaxone as prophylaxis for almost anything. It's been such a good drug with such a good spectrum, it would be a shame to ruin it because someone wants to bring a big gun to a knife fight. Joe P.
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