| Author | 12 Posts |
Perhaps
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3 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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| shumaila
Forum Elite
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E?
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| Perhaps
Forum Elite
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Most people think E
I was thinking why not A
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| achilles
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ampicillin increases the chances of yeast infection. bactrim is preferred at this gestational age. its almost at term now.
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| soujany
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I too think the answer is A. Trimethoprim-sulfa is associated with increased risk of chances of displacement of bilirubin and hence the risk of Kernicterus. Tetracyclines cause bone problems & gray baby syndrome. Ciprofloxacin may cause problems to the growing cartilage. And finally clindamycin doesn't give coverage for the organisms causing uti. So excluding all these I feel the answer is Ampicillin. The other drug that can be used is Nitrofurantoin for 7-10 days.
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| Perhaps
Forum Elite
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The kernicterus is what I am thinking too. But ampicillin has to be injected...
Not sure
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| djacosta
Forum Newbie
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amp
http://www.emedicine.com/MED/topic3089.htm#sectio...
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| humbty
Forum Elite
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According to emedicine I would say Bactrim shouldnt be used in the 1st and 3rd trimester right? Or whats your understanding?
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| djacosta
Forum Newbie
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i think amp is catog B and bact is catg C and so i would just go with amp...
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| frank100
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(a) also
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| study_ing
Forum Fanatic
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A. TMPsmz shud not be given in the third trimester as it displaces bilirubin.
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| juanma0
Forum Senior
Topics: 10
Posts: 146
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Diagnosis : Asymptomatic Bacteriuria
TX :
Nitrofurantoin (class B)
Ampicillin (class B), single dose or divided.
TMP-SMX (class C) CI in pregnancy and breastfeeding
(source PDR 2006)
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