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Asymptomatic GBS bacteriuria during antenatal visits

To treat or not to treat?

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doi: 10.1097/01.NPR.0000684268.11190.66
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INSTRUCTIONS Asymptomatic GBS bacteriuria during antenatal visits: To treat or not to treat?


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Asymptomatic GBS bacteriuria during antenatal visits: To treat or not to treat?

General Purpose: To gain information on current recommendations regarding treatment of asymptomatic group B Streptococcus (GBS) bacteriuria during antenatal visits. Learning Objectives: After completing this continuing education activity, you should be able to: 1. Summarize etiology, complications, previous study results, and findings of the authors' internal case review of asymptomatic GBS bacteriuria during pregnancy. 2. Identify current recommendations for screening, diagnosis, and treatment of antenatal asymptomatic GBS bacteriuria.

  1. Since the initiation of guidelines in the 1970s for intrapartum antibiotic prophylaxis for GBS, incidences of neonatal sepsis have
    1. decreased.
    2. increased.
    3. remained unchanged.
  2. For diagnosing prenatal asymptomatic bacteriuria (ASB), a urine culture should be performed at
    1. 12 to 16 weeks gestation.
    2. 22 to 27 weeks gestation.
    3. 32 to 36 weeks gestation.
  3. Maternal GBS bacteriuria increases risk for chorioamnionitis, which causes
    1. uterine tenderness.
    2. maternal bradycardia.
    3. maternal leukopenia.
  4. A study by Thomsen and colleagues revealed that treatment with penicillin for GBS ASB at any colony count reduced rates of
    1. pyelonephritis.
    2. postpartum endometritis.
    3. preterm rupture of membranes.
  5. In the authors' internal review of 31 cases with GBS bacteriuria, preterm birth occurred in
    1. 2 cases.
    2. 12 cases.
    3. 25 cases.
  6. In the authors' internal review, 25 cases of GBS ASB were initially treated with antibiotics, then treated again
    1. during labor.
    2. one week later.
    3. after delivery.
  7. The authors' internal review revealed one case of chorioamnionitis occurring after initial GBS bacteriuria treatment early in pregnancy with
    1. cephalexin.
    2. clindamycin.
    3. nitrofurantoin.
  8. The authors' internal case review revealed 5 local cases of GBS bacteriuria resistant to which antibiotic?
    1. amoxicillin.
    2. clindamycin.
    3. nitrofurantoin.
  9. What did early studies reveal about most participants treated with antibiotics for antenatal GBS colonization?
    1. GBS did not recolonize.
    2. GBS recolonized only after delivery.
    3. GBS recolonized within 3 weeks.
  10. According to 2019 guidelines, GBS ASB at a threshold of at least 105 CFU/mL during pregnancy should
    1. not be treated with antibiotics.
    2. be treated at time of diagnosis.
    3. only receive treatment if fever occurs.
  11. If treating GBS bacteriuria during pregnancy with 500 mg of amoxicillin, this dose should be administered
    1. once daily.
    2. twice daily.
    3. three times per day.
  12. The antibiotic of choice for prenatal GBS is
    1. penicillin.
    2. clindamycin.
    3. nitrofurantoin.
  13. New 2019 guidelines include specimen collection for universal GBS screening with
    1. cervical swab.
    2. vaginal-rectal swab.
    3. mid-stream urine.
  14. The World Health Organization recommends a 7-day antibiotic regimen for ASB during pregnancy to prevent neonatal
    1. sepsis.
    2. low birth weight.
    3. respiratory distress.
  15. For prenatal GBS bacteriuria, recommended dosing for clindamycin includes
    1. 100 mg twice daily.
    2. 300mg every 6 to 12 hours.
    3. 500 mg four times daily.
  16. With antibiotic resistance on the rise, definitive antibiotic therapy for GBS should be based on
    1. patient tolerance and preference.
    2. clinician preference and patient cost.
    3. culture and guided by the sensitivity pattern.
  17. To avoid predisposing the neonate to kernicterus, after 36 weeks gestational age avoid prescribing
    1. cephalexin.
    2. Penicillin VK.
    3. nitrofurantoin.
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