GBS prophylaxis med error

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Specializes in NICU, NSY, LD/OB.

When a GBS pos mom misses her 2nd dose of Q4 penG, delivers 6.5 hrs after the first dose was on board, is her child considered "gbs pos but adequately treated" or "gbs pos inadequately treated" and can anyone guide me to a reference about this type of situation.

This resulted from a med error (med missed at change of shift), and I am wondering - - if the kiddo is covered by the one dose 6.5 hrs prior to delivery (as this one was deemed to be by the docs) then why do we give a second dose at all? Why dose every four hours? Why can we not just give mom one dose and be done with it?

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Specializes in NICU, PICU, PACU.

I believe ours is within 4 hours of delivery or completed course, so that would be inadequetely treated where I work and the kid would get a workup and 48 hours of antibiotics. So yes, that is a med error that results in further treatment.

GBS is a tricky bug....if not treated correctly the kiddo can have a latent infection, which usually shows up after discharge and can be fatal. Before we started on the 4 hours before delivery years ago, this was a common outcome :(

Here is a great link for the CDC guidelines. GBS is nothing to mess with!

http://www.cdc.gov/groupbstrep/clinicians/QAs-obstetric.html

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Specializes in NICU, NSY, LD/OB.

Thank you. I thought that the kiddo should have been treated as inadequate coverage gbs pos kids are, but was overruled and it made me uncomfortable, so I pursued it to the neo and was double-overruled. :-(

I am now looking for documented authoritative resources for the NEXT time this happens to me.

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interesting to see how it's supposed to work at a delivery hospital. I don't work at one but work in a childrens hosp nicu and took care of a poor baby with late onset gbs meningitis, it was awful and it killed him :-(

Definitely not something to mess with and I figure, it it were my kid, better safe than sorry, no real harm in treating just in case

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Specializes in NICU, PICU, educator.

http://http://www.cdc.gov/groupbstrep/guidelines/downloads/secondary-prevention.pdf This is under neonatal. They "could" send the kid home but they have to document that they instructed the mom on what to watch for. Scary to me.

We would have worked the kid up too. Late onset GBS is awful, one of the worst things I have seen, kid seems fine and then starts to not eat well, gets cold and is in septic shock before you can say Mary Poppins! I would be uncomfortable with that too, but if they signed it off it is on their heads if something goes wrong :(

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