Herb, \When you say "House Staff" do you mean as in "Teaching" residents how to do things, or do you mean hospitalist? I cannot imagine a teaching program using PO meds for GBS. We had one re-develop GBS (temp 100.2 and fussy + blood culture) 48 hrs after 8 days of abx for "uncomplicated" septicemia. I don't think there is such a thing as uncomplicated GBS disease. Did your 5 day old grow out GBS? I must have missed that post. But as far as the amt and duration of therapy, We are going 14 days of 300mg/kg/d div q6. I think the red book says 14 days for meningitis, not 10. -gb ----- Original Message ----- From: "Herb Ruhs" <> To: "Vicki L Soloniuk" <> Cc: <> Sent: Wednesday, October 31, 2001 3:19 AM Subject: Re: GBS in a 13 day old Hi folks, An update on my 5 day old with partially treated GBS and clinical sepsis with neutropenia on day 3, poor feeding and blood cultures x 3. A bag urine (mea culpa, the cath didn't work) grew >100,000 E. Coli. The same day I accidentally got the results on the bagged urine (lab informed no one and I don't have a code to get into the computer myself) he ran out of IV sites that the nurses at this small hospital could utilize. They wanted me to start a central line, but I had grave misgivings about managing a central line, particularly since I was leaving the hospital in two days for good. He had completed a little over 48 hrs. Amp and Claf when the consulting neonatologist accepted him for completion of 10 day course. To "facilitate breast feeding" this infant was admitted to the ward where a local ped doing part time attending and the house staff hijacked him and decided that all he needed was PO Suprax and sent him home! I should have "DON'T CALL 911" tattooed on my fore arm where I can see it when I reach for the phone. This is one of those "God give me the serenity to accept the things I can not change..." situations, but I still feel really rotten. Hope he does OK. herb Vicki L Soloniuk wrote: > > I have not seen GBS in kids where mom has had 2 doses of PCN but have had a > case where mom had 2 doses and the kid developed pneumonia clinically and on > CXR with negative cultures. Not sure if the intra-partum ATB's suppressed the > cultures but went ahead with a full course of ATBs. > > BTW, welcome back, Herb. The kid you're describing sounds septic and I would > give it another day or two to respond to ATBs. > > Vic > > Jon Slater wrote: > > > One of my colleagues had a 3 week old baby that presented with GBS that was > > treated appropriately and did well for about 2 weeks before re-presenting. > > Last I heard, the child was being referred for an immunology work-up. > > > > Jon > > > > -----Original Message----- > > From: [mailto:]On Behalf Of > > Graham Barden > > Sent: October 28, 2001 7:17 AM > > To: > > Subject: GBS in a 13 day old > > > > I have an interesting infant. Full term infant born to a GBS+ mother after > > two > > dosages of ampicillin. Infant did well and was breast fed. At 13 days the > > infant > > was feeding well during the day, but did not take the 6pm feed. Mother was > > concerned, took a temp and found 101. She went to the ER, was evaluated and > > referred for admit despite no temp. I saw the infant, and was clearly > > irritable. > > Blood, urine, CSF cultures. CSF had 13 WBCs, 3,000 rbc's. CBC nl. I started > > amp > > and gent. Blood culture positive at 12 hrs, and csf at 24. Both GBS. Now we > > are > > treating for 14 d. Infant has done quite well. > > Have others seen GBS despite the two maternal dosages of ampicillin? > > -gb