Postup při prevenci neonatálních nákaz streptokoky skupiny B

Předčasná dirupce vaku blan  (<37. týden gestace)

Management should be discussed with a consultant obstetrician

• Generally conservative management should be adopted before 34 weeks to achieve maturity of fetus and allow administration of steroids
• Between 34-37 weeks the decision is individualised, with a greater leaning to delivery as the gestation and or period of ROM increases

Where conservative management is appropriate, these women should receive:

• Erythromycin PO 250mg qds for 10 days or until labour/delivery.
• Betamethasone 12mg x 2 doses 24 hours apart if less than 34 weeks gestation.
• Intrapartum antibiotic prophylaxis as for PPROM with GBS cariage is advised because of the combination of risk factors for GBS disease (prematurity and prolonged ROM). Therefore give: 
  • Benzylpencillin IV 3g stat then IV 1.2g 4 hourly until delivery
  • If penicillin-allergic, Clindamycin IV 900mg 8 hourly until delivery.

  NB This dosing has been agreed with microbiology, it is acknowledged that this is a slight variance with RCOG recommendations

  If Chorioamnionitis is suspected then broader spectrum antibiotics are required- See Chorioamnionitis page

   

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Stránka naposledy editována: 07/04/2010. Copyright .

Originální stránka

Upozornění; Dávky antibiotik doporučované na těchto stránkách jsou určeny pro pacienty s normální funkcí ledvin a jater, není-li uvedeno jinak. Doporučené dávkování u pacientů se sníženou vylučovací schopností ledvin je  zde.