GBS treatment??

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    Hi everyone, I'm hoping someone can help me out here since this type of nursing is REALLY not my strong point! My sister just called and told me that her doctor told her she has GBS, to be treated at time of labor/delivery. My sister is on Macrobid now for UTI. She's wondering if this Macrobid will help with the GBS now? She's actually on her second course of it. From what I can gather on my weak internet search, they're treating her because her UTI is symptomatic, not to treat the GBS. It looks like that's treated with PCN or clindamycin at the time of labor/delivery. Can anyone tell me if this information is correct? Anything would be appreciated. My sister realizes this is fairly common, but is still a bit nervous. Thanks in advance!! :kiss
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    At my hospital we treat with ampicillin. The ped doctors like us to get 2 doses in the mom before she delivers. GBS is more of a problem for the infant than mom. We keep the babies for 48 hours after delivery to observe for symptoms.Also we do blood cultures and prophylactic antibiotics on the baby if the mom doesn't get 2 doses of antibiotics.
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    You are right, her current antibiotic therapy is intended to treat her UTI, not her GBS colonization. It is important that she take it as ordered, because untreated UTIs can cause preterm labor.

    About half of all women of childbearing age are colonized with GBS, which poses no risk to a healthy mother. Once the membranes rupture during labor however, these bacteria can come into contact with the infant, possibly resulting in life-threatening infections including pneumonia and sepsis. It is now the standard of care to screen all pregnant women during the 3rd trimester for GBS colonization. If they are found to be positive, they are treated with antibiotics during labor in an effort to prevent transmission of the bacteria and infection of the newborn. After birth, their babies also receive appropriate intervention, which may include observation for signs and symptoms of infection, lab work, and antibiotic therapy.

    At one time, an effort was made to treat pregnant patients with GBS prenatally with oral antibiotics. This was largely ineffective, however, as many were leery of taking antibiotics during pregnancy, and many became re-colonized prior to delivery.

    Good luck to your sister and her family!
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    Thanks a lot for the great info!!
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    wishing her luck and a happy/healthy delivery! IV antibiotics are the GOLD standard in preventing transmission of GBS in labor and delivery. None of the docs/midwives I work with uses prenatal antibiotics for GBS colonization. Like said above, UTI is a separate issue and it is critical to see that treatment through. Expect she will be adminstered IV antibiotics (usually -cillings unless allergic, then she may get clindamycin). I wish her and her baby well.
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    Thanks Smilingblueyes!!
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    Originally posted by SmilingBluEyes
    IV antibiotics are the GOLD standard in preventing transmission of GBS in labor and delivery.
    This was one of our monitors this year. Too many of our moms weren't getting treated in time. I'm assuming it was a pharmacy issue, because L&D started keeping PCN in the pyxis for quicker administration, and we have somehting like 90$ increase in timely treatment.

    Of course, we still have to transition baby, but it sure does save the baby alot of bloodwork and cultures!

    It is my understanding that the docs are stressing the importance of getting to the hospital quickly to start treatment once labor has begun. Our hospital's policy is at least one, but preferably 2 rounds of PCN at least 4 hours before delivery. Anything less that that is considered "not treated" and full work-up is required.

    Heather
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    Heather, where I work, we also urge moms to come on as soon as they believe their membranes MAY have ruptured or regular contractions have begun if GBS +. We explain CLEARLY why it is so important they get there as soon as they can due to our need to initiate medication promptly.

    Our standing Tx is ampicillin 2 grams, IVPB, immediately--- and in 4 hours and then q6h afterward. If we manage only ONE dose, the baby stays 48 hours, for observation, but NO work-up is initiated unless he/she is symptomatic. (whew).....

    We also keep 2 Gm vials of ampicillin in our floor stock, ready for immediate mixing and administration as any moment. This is especially important during night shift, as you can imagine, since we have NO pharmacists in-house and the supe has to go get it for us if after 11 p.m. This protocol works VERY well for us and I have not read of or heard of babies having trouble following it this way.
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    Thanks again everyone for all the information. My sister was unfortunately admitted to the hospital yesterday. She had a fever for over 24 hours and yesterday was shivering uncontrollably. They've done tests and think it's a kidney infection. As of right now, the baby is fine and my sister's fever has broken and she's feeling much better. They're keeping her for at least one more day to wait for test results and for observation. Looks like everything will be okay! Thanks again, everyone!
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    awww hope she will be ok....she and her baby are in mythoughs.


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