Re: 32 week PROM Recent Herpes outbreak 30182261 - HOT SILVER METALLIC HOBO P...
From: Anna Meenan, MD (annam@uic.edu)
Tue Jan 18 20:14:27 2005
You forgot to add the increasing incidence of antibiotic resistance in
our hospitals. Our hospital has a standing order for beta-strep
positivity that includes penicillin, and then a second standing order to
change the order for penicillin to ampicillin, because penicillin is
never available.
--
Anna Meenan, MD
At Tue, 18 Jan 2005, Garry E. Siegel, M.D. wrote:
>
>Kay:
>
>I respectfully submit that those Obstetricians and midwives are
>practicing below the standard of care, not beyond it. If you will
>accept that the CDC and ACOG "know" more than the average practitioner,
>then why are they so smart to do counter to that which is recommended?
>
>Your presence and discussion in this forum demonstrate your thirst for
>learning and your desire to practice in an informed manner. Use this as
>a springboard to educate others. Lead, do not follow here. (We miss
>Zach, so I had to try to emulate him :)).
>
>Comments below.
>
>Garry
>
>>I've just conducted a mini survey among several doctors and midwives and the consensus is that everyone DOES give antibiotics in this case. The reasons are
>>
>>1. The beta-strep is often positive.
>
>30% across the board is the approximate colonization rate. Often????
>
>>2. There's no harm in giving penicillin.
>
>Kay, there sure can be, including but not limited to: antibiotic colitis
>in the baby, anaphylaxis in the mother. . .again, uncommon but if you
>have a complication due to an unnecessary treatment, you've done the
>wrong thing.
>
>>3. The pediatricians will treat the baby as a positive baby and will order all lab tests including blood cultures, mandate a 2 day stay and will start antibiotics with any slight deviation from normal.
>
>I just discussed this with our head nurse at North Fulton. Nowhere in
>the guidelines should the OBSTETRIC management be dictated by the
>presumed neonatal management.
>
>Kay, practice good medicine according to national accepted standards,
>and you'll be OK.
>
>Garry
>
>>--
>>Kay Johnson, CNM
>>Atlanta, GA
>>~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
>>"Life is too important to be taken seriously."
>>Oscar Wilde
>>~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
>>
>--
>Garry E. Siegel, M.D.
>Private Practice
>Roswell, GA
>
