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Re: Question about GBS treatment in labor vs prenatallyFrom: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C. (johnprov@sympatico.ca)Sat Aug 25 04:44:22 2007
Some very simple concepts here, first we are not treating infection when we give prophylasis, though infection with intact membranes and no labour has been described it is almost unheard of. They were giving I.V. or I.M. pen G here, means you bring in Mom when you get the swab back positive, it is known that I.V. penG gives higher intial tissue levels than P.O. one of the reasons you treat tertiary syphilus and infected joints with I.V. pen G. Finally take everything we now do for GroupB strep with a big grain of salt, the infection rates where falling rapidly even before universal screening and prophylaxis was implemented. Group B strep is probably present in small amounts even with negative swabs, a positive swab is an indication that that load of bacteria is enough to warrant prophylaxsis. If someone did a trial comparing universal antibiotics in labour irrespective of groupB or other status I am sure they would find a significant clinical difference in infection rates if we just gave antibiotics to everyone , do we really want to go there.
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Take care, John
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