Perhaps
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A 19-year-old primigravid woman at 34 weeks' gestation comes to the physician for a routine prenatal visit. Her pregnancy has been uncomplicated. She has no history of serious illness. She takes no medications and has no known allergies. Examination shows a uterus consistent in size with a 34-week gestation. A routine clean-catch urine culture grows greater than 100,000 colonies/mL of Escherichia coli. Which of the following is the most appropriate pharmacotherapy? A ) Ampicillin B ) Ciprofloxacin C ) Clindamycin D ) Doxycycline E ) Trimethoprim-sulfamethoxazole
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| neo335
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according to kaplan.. shalaka.. we donot treat her now if she is asymptomatic.. what we do is giv her iv penicillin G at time of delivery.. . coz he said that if we Rx her now.. she may get it again.. so Rx her to protect the baby at labour...
i however cudnt make much out of it, but thats what he had said.. n so i remeber it well. any1 please correct me... n what shud we choose amongt the option givn above?
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| shumaila
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well i think answer is trimethoprimsulfmethoxazole if we do not treat her there is risk of developing of pyelonephritis
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| humbty
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She has asymptomatic BACTERIURIA thats always treated in pregnancy.
I think your confusing that with STREP B culture Neo.
E.coli Bacteriuria is always treated and I read different opinions some say Bactrim is ok in pregnancy others say no. I dont know the answer. UW says no Cotrim in pregnancy. I m confused.
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| neurogirl
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I think it's A
Ampicillin is the safest drug in pregnancy used to treat UTI's
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| Perhaps
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Thanks everyone!
I was choosing between A and E also. confused
A has to be injected instead of oral, right? if that's true, will it make E more likely?
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| humbty
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Yes you are right as far as i know Ampicillin has to be given IV and Amoxicillin oral. so Ampicillin is somehow únlikely
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| neurogirl
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From UW:
Treatment of asymptomatic bacteriuria in pregnant patients consists of 7 to 10-day course of nitrofurantoin,ampicillin or first generation cephalosporin.Trimethoprim and sulfamethoxazole is associated with fetal problems like kernicterus and should be avoided in pregnancy.
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| SilatK
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Ampicillin can be giving orally and she should be treated. Trimetropim and sulfamethoxazole can be giving but not recomended on the last weeks or pregnancy . Specially after 36 weeks since birth can be expected at anytime now and if under this med, the baby's liver is not mature enough to metaboliza the drugs and can be a cause for jaundice.
Answer is A
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